HIP/EMBLEM a NY insurer that covers 4 million lives of government workers primarily has just reduced the global fee from $55 to $45 statewide citing that it is “in line with patterns in the industry” and that the old reimbursement rate of $55 was “well above the industry norm”.
Help me out here Mr. Anthony Watson (CEO) and show anybody any kind of data that $55 or $45 is within any norm in the industry. The only published benchmark is CMS data and an extrapolation of that data for New York and in particularly in the city where rents are $30–$40 more approximates $90 and industry trends and work comp are negotiated above CMS rates. I promise we can show you more data of CEO’s taking reduction in compensation versus doubling their take home.
The fundamental question is how can this happen? The conventional wisdom is “cause they can”. This is unfortunately true if too many unwise providers accept rates that will make them go the way of Shakers. Perhaps HIP/EMBLEM and their bloated CEO don’t remember the mass providers who finally said no to the ridiculous rates by the former ACN division of UHC.
It’s a good thing PT’s like Dr. Dimitrios are not afraid to go public and is going one step further by leading his staff to HIP offices in NYC to protest this impending 20% reductions.
Watch Dick Brennan’s TV report here.
