From WisPolitics.com/WisBusiness.com …
— UW Health is accusing Anthem Blue Cross and Blue Shield of making an unfair offer amid ongoing negotiations, while the insurer says the health system is seeking “drastic” price increases.
Negotiations have been happening for several months, as an agreement between the organizations is slated to expire April 15, the health system said today. In a statement, Madison-based UW Health said Anthem’s current offer “is neither fair to their members nor our care teams,” arguing the insurer has agreed to “much higher” reimbursement rates for other health systems in the state.
“Despite that fact, Anthem has proposed that UW Health receive an increase well below the rate of inflation,” the health system said. “Anthem is also demanding the ability to unilaterally change payment terms without a renegotiation, which can put patient care at risk.”
In a statement responding to UW Health, Anthem Director of Public Relations Emily Snooks says the health system is requesting a 32% price increase over three years for Anthem members.
“This increase is more than four times the current rate of inflation in the first year alone for care at certain UW Health facilities,” Snooks said. “Standing against unprecedented and irresponsible price hikes is part of our mission and we will continue to protect access to affordable care for all Wisconsinites.”
Along with criticizing Anthem’s offer, UW Health said many of its patients “struggle with the overuse of prior authorization requirements” imposed by the insurer. Such requirements allow insurers to review and approve certain medical services before they’re provided as a way to control costs.
“We recognize that Anthem’s $6 billion in annual profit is built on deals like this, forced upon health systems and their patients,” UW Health said. “However, we continue to negotiate in good faith for a fair deal on behalf of our patients and the 25,000 UW Health team members that provide them care.”
While patients with Anthem insurance are currently still in network with UW Health and its affiliates, that will no longer be the case after April 15 if the organizations don’t reach an agreement by then. The health system says it’s notifying patients of this potential change.
Snooks says Anthem wants UW Health to remain in network and will keep working toward an agreement, but adds “we cannot agree to excessive price increases that would only make health care less affordable for our members.”
Meanwhile, UW Health also says it’s encouraging patients with Anthem insurance to contact their employer to advocate for keeping the health system in network, or call Anthem directly with the same appeal.
See UW Health’s full statement in the release below.
— In a “promising sign” for the fight against the opioid epidemic, overdose deaths in Wisconsin are on the decline as hundreds of millions of dollars in settlement funds flow into the state.
That’s according to the latest report from the Wisconsin Policy Forum. It shows opioid overdose deaths in the state in June 2024 had dropped to their lowest level since early 2020, with 1,075 deaths occurring over the 12-month period ending in June.
Report authors note the total deaths “remain daunting and could still be revised,” as the figure is based on provisional federal data. Plus, deaths in Milwaukee County haven’t seen as much of a decline as the rest of the state.
“If they hold, however, they would indicate a continued downward trend in opioid deaths that started toward the end of 2023 — not just in Wisconsin, but nationwide,” they wrote.
This trend is taking place as the state and local governments have received $208 million of the $780 million coming to Wisconsin through 2038 from opioid settlements, the report shows. At the end of last year, the state had gotten $75.3 million and allocated $64.4 million of that total, with $15.4 million having been spent. And local governments had gotten about $123 million by the end of 2024.
Opioid settlement spending data isn’t yet available for most local government recipients in Wisconsin, the report shows. But the Department of Health Services has directed state-level funds toward expanding treatment facilities, tribal government efforts, expanding an overdose reversal program, providing fentanyl test strips, and helping to cover room and board costs for residential opioid treatment.
WPF says the downward trend for opioid deaths is “welcome news” after decades of increases, but adds policymakers are now faced with the difficult task of figuring out which approaches are having the greatest impact. The group points to research that suggests the national decline “might be more attributable” to changes in the fentanyl supply that have reduced its potency and availability.
“The nature of illicit opioids — what form they come in, what non-opioid substances are mixed in, and more — changes over time, and this can impact outcomes and programming such as the number of overdoses, efficacy of certain treatments, and more,” authors wrote.
See the report.
Top Stories
– Iowa has high cancer rates. Trump’s cuts to CDC and NIH are already hitting the state
– Trump: Iowa should pass measure removing protections for transgender people ‘as fast as possible’
– US House Democrats press Kennedy over health agency firings
– U.S. health agencies participated in WHO flu meeting despite planned exit
– In Texas Measles Outbreak, Signs of a Riskier Future for Children
– Democrats hit the airwaves to bash Republicans on Medicaid
– Future of Cancer Coverage for Women Federal Firefighters Uncertain Under Trump
Press Releases
– UW Health: Statement from UW Health on Anthem Blue Cross Blue Shield negotiation
– UW Health: Child’s rare condition diagnosed after 14 years of searching
