Let?s Preserve Affordable Health Care Choices (Sharon Allen Commentary)

As a nonprofit mutual insurance company, Arkansas Blue Cross and Blue Shield has as its primary mission providing health care financing products with as much choice and affordability as possible.r

To do this, Arkansas Blue Cross and its affiliates negotiate discounts from providers to make health care as affordable as possible for our customers. Hospitals and doctors are offered the opportunity to be in-network providers for certain insurance products like preferred provider organizations (PPOs) and health maintenance organizations (HMOs). Providers get a steady flow of customers and timely payment for their services. Patients get the care they need. And the purchasers of these insurance products get coverage at a more affordable cost.r

We believe that our provider network arrangements offer Arkansans a wider array of choices than our competitors, offering consumers a good balance of choice, coverage and affordability. Our networks include six hospitals in the Little Rock Metropolitan Statistical Area, a four-county area that has nearly twice as many hospital beds as the national average, according to a study by the Center for Studying Health System Change.r

We sell products that pay for covered services of any doctor or hospital. All Arkansas doctors and hospitals in good standing are eligible to participate in the Arkansas Blue Cross “Blue Book” network.r

Some customers prefer products that have lower premiums but still have benefits available if a need arises to go outside a network. PPO and point-of-service products are available for those customers. And PPO rates in the Little Rock MSA were 13 percent less than the national average, according to another report by the CSHSC.r

More choice of providers and more coverage cost more. Less choice and less coverage cost less. We offer a variety of combinations and let our customers decide. And, of course, there are other network options available from other insurers. Different insurance companies offer different networks, which leads to healthy competition. And every hospital and doctor in our networks is free to participate in the networks of our competitors.r

Arkansas Blue Cross has consistently fought to hold down health care costs and provide our customers with affordable health insurance. In doing this, we have fought against unnecessary expansions of provider networks that would merely duplicate services and increase costs.r

In 1995 Arkansas lawmakers passed “any willing provider” legislation, requiring health plans to contract with any provider willing to accept their terms and conditions. We knew the 1995 law would only increase premiums while depriving our customers of the PPO and HMO options they had selected. What any willing provider actually does is eliminate the ability of employers and health plans to design and select alternative products that cost less.r

Proponents argued that consumers should be able to choose their providers. We agreed with that concept. That’s why, after the 1995 statute was invalidated by federal trial and appellate courts, we worked with providers, employers, state legislators and others to pass the “Freedom of Choice Among Health Benefit Plans Act of 1999.” This 1999 law gives Arkansas citizens the right to choose a plan with access to services of “any qualified health care provider,” placing choice at the consumer level.r

Another study by the CSHSC reported what recently happened when major health insurance companies in Greenville, S.C., were induced to accept both major hospital systems rather than having an arrangement with only one: The health insurers lost the deep discounts they had negotiated for their customers, with higher premiums to customers likely to result.r

Last month, Arkansas Blue Cross and Blue Shield and its subsidiary, USAble Corp., asked the U.S. District Court in Little Rock to determine the status of the 1995 “any willing provider” law. There were differing opinions about the effect of a U.S. Supreme Court decision on a similar law passed in Kentucky. We initiated this action to clarify the law in Arkansas. And, we are committed to preserving choice and keeping health care as affordable as possible for our customers and all Arkansans. r

(Sharon Allen is president and chief operating officer of Arkansas Blue Cross and Blue Shield, a mutual insurance company.)