Medicare, Blue Cross Blue Shield rank as top insurers by ambulatory providers, peer60 report says
Providers like Medicare's reliability compared to private insurers that some ambulatory care systems likened to a moving target.
Medicare is ambulatory care's favorite insurer when it comes to getting paid faster, according to a new peer60 survey of close to 800 ambulatory care providers.
Despite the paperwork that goes along with getting paid by a behemoth government agency, providers like Medicare's reliability, compared to private insurers that some ambulatory care systems likened to a moving target, peer60 said.
Overall, providers ranked Blue Cross Blue Shield as their favorite payer, according to the study. This is because of BCBS's ability to stay close to its customers and the markets in which its franchises operate, said Executive Vice President Chris Jensen.
BCBS was the overall favorite among 22 percent or providers surveyed, followed by Medicare at 16 percent. UnitedHealthcare, the nation's largest insurer, came in a distant third at 9 percent.
Credit: peer60
Aetna ranked at 6 percent for favorite payer, followed by Cigna at 5 percent, Anthem at 4 percent, Humana at 3 percent and Tricare at 2 percent.
On the other hand, UnitedHealthcare ranked as the least favorite payer, according to peer60, since the ambulatory providers found UHC more difficult to work with than the competition.
The top cause for dissatisfaction among providers is wasted staff time, followed by denied claims and poor customer service, the report said.
Peer60 recommends insurers find ways to free up hospital staff through better training, software or other means.
Mergers that could stifle competition also has providers worried, according to Jensen, who said the study wanted to see where the provider and payer relationship is going, especially among health insurers which have acquired hospitals and physician groups.
"The hope is that as insurers acquire more hospitals and physicians, they will learn from these important entities and provide better overall offerings and services," the report said.
Credit: peer60
The quickest way to a provider's heart is faster reimbursement, according 50 percent of those interviewed, followed by less staff time, denial of fewer claims, better customer service, less paperwork, good pre-certification and easier negotiations.
The top 10 payers control 60 percent of the contracts, according to Jensen. The top payers in terms of contracts are UnitedHealthcare and Blue Cross Blue Shield, which each have 9 percent of contracts among ambulatory providers; followed by Medicare and Aetna, each at 8 percent; Cigna, at 7 percent; Medicaid at 6 percent; Humana at 5 percent; Tricare at 3 percent; Anthem at 3 percent; and Coventry at 2 percent.
Survey feedback, in order of largest to smallest segment which responded, came from physicians, nurses, CEOs, IT managers, other, administrators and financial leadership.
Twitter: @SusanJMorse
