During the pandemic, the medical community was doing its best. Practices and hospitals faced higher costs, fewer visits and patients postponing routine health maintenance. PPE was not cheap. Staffing became more expensive. For many health providers, the bottom line was precarious.
Meanwhile, Cigna and other health insurance companies collected premiums while patients avoided care, giving the companies a huge windfall. Yet, some health insurers are still not satisfied with this extra cash. Specifically, Cigna is putting the squeeze on doctors, hospitals and patients.
We were first aware of this when a letter arrived from Cigna.
Here in our region, there is basically one major health system. Cigna is now renegotiating its contract with this large health system, threatening to eliminate its participation from the plan. They decided to also threaten the doctors who work with this large hospital system. Cigna announced it will cut the hospital system out of its network in a matter of days. In addition, it will cut all doctors out of its network who refuse to get privileges at another hospital and send their Cigna patients to this other hospital.
“You must have unrestricted admitting privileges… with at least one hospital that participates in a Cigna network…If you do not (since Cigna is leaving two hospitals in your area), this letter will serve as a formal notice that you no longer meet the requirements to be a participating provider and you will be removed from Cigna’s network June 1, 2021.”
Basically, doctors are supposed to immediately run out and get privileges at another smaller hospital with more limited capabilities, creating additional patient risk. Any medical person with any hospital exposure can tell you the application process for hospital privileges is time-consuming and difficult. The suggestion that a doctor should suddenly leap, at the demand of an insurer, to get admitting privileges to another hospital within weeks is patently absurd!
The doctors in our practice are also supposed to sign a pledge that says we will only send Cigna patients to this small hospital.
If I have any questions, I am encouraged in the letter to call the generic Cigna Patient Customer Service number and die of old age navigating their phone tree. The letter gives no realistic contact option. It is basically a missile launched at healthcare workers from a fortified executive bunker. Cigna’s message is clear: “We just threatened you, but we do not want to hear from you.”
Remember all of those emails in 2020 about Cigna and similar insurances, wanting to support healthcare workers in the pandemic? Yep. It pretty much ran out.
Fortunately, Cigna services only a small percentage of patients in our area.
I understand the game here: The insurance company postures and threatens, causing fear and anxiety, hoping to sway public opinion against our major hospital system.
Let us pause for a moment…
No other organization has provided so much support for Covid-19 patient care as our large regional hospital system. I say that as a fiercely independent practice owner who is skeptical of hospitals in the extreme. Our largest hospital system was the first to announce early Covid-19 testing. When the ICU beds were filling, this system added capacity at great expense while the competing system, demanded by Cigna, curtailed its ICU, mandating transfers to systems an hour or more away. Monoclonal Covid treatment is only offered regionally at the one system Cigna will ban from its patients.
The majority of Cigna patients will lose their primary care doctors.
I have been a practicing physician for more than three decades in a variety of markets and circumstances. I have witnessed serious showdowns between hospital systems and insurance companies. Some of these standoffs have gone very badly for patients. I understand the brinkmanship. Creating such a scare-inducing letter for the doctors was simply part of the process.
Our group agreed to participate with Cigna very reluctantly years ago. There is a significant hassle factor with this company. Now, the company is showing amazing audacity. We are doctors, doing our best to care for Cigna patients, never challenging them to any contract dispute, and we are now getting kicked out of Cigna because the company is putting the squeeze on the hospital. Our practice and our patients are mere collateral damage.
Even if we choose to see Cigna patients out of network, the act of ordering CT scans, MRI’s or other complex studies will involve patients having to travel many miles away. While we in healthcare fought on the frontlines, Cigna cowardly hid in its bunkers, trying to squeeze more money for executive bonuses.
Here is what you accomplished, Cigna. We have no interest in playing your game. Feel free to kick us out. Posture away, but don’t think you can recruit us to your nasty little war. GET OUT OF MY TOWN!