Health insurers and hospitals keep fighting. David Williams is quoted in the Boston Globe
Not every game of chicken ends up with one car swerving to avoid impact.
David Williams was quoted in the Boston Globe (Thousands are scrambling after learning their insurance will no longer cover care at UMass or Children’s hospitals)
It just may not be possible for lower-priced health plans to afford these costly providers.
“It’s definitely a game of chicken,” David E. Williams, president of the Boston consulting firm Health Business Group, said of negotiations between health systems and insurers. “Usually, they work it out, but not always.”
In the case of Point32Health, the state’s second-largest health insurer — which formed in 2021 when Tufts Health Plan merged with Harvard Pilgrim Health Care — said that Children’s and UMass Memorial wanted to charge too much for care. Point32Health said it couldn’t pay the higher rates and keep premiums affordable.
“We were far apart, and Boston Children’s and UMass determined they would no longer participate” in that plan, said Philip Tracey, a spokesperson for Point32Health. He added, “This is not an uncommon occurrence. Providers leave networks for various reasons.”