Patients caught between Blue Cross an...

Patients caught between Blue Cross and Condell

There are 36 comments on the Chicago Tribune story from Oct 9, 2007, titled Patients caught between Blue Cross and Condell. In it, Chicago Tribune reports that:

Two dozen Lake County physicians on Tuesday accused Blue Cross Blue Shield of Illinois of using patients as pawns in the company's high-profile contract dispute with Condell Medical Center.

Join the discussion below, or Read more at Chicago Tribune.

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Lake County resident

Monticello, IN

#1 Oct 9, 2007
this stinks
Specter

Chicago, IL

#2 Oct 10, 2007
We need universal, single payor healthcare NOW! It's beyond time for change. These private insurance companies are driven by one thing -- profit. And in the process, the US healthcare system is still being held hostage, continuing its costly descent into the provervbial toilet. We are the only nation in the world with such an abominable private system, we spend more than any other country on medical care, and yet still, we have 40-50 million uninsured and our life expectancies and health outcomes trail those found in Eastern Europe. Disgraceful.
bob sigmond

Crum Lynne, PA

#3 Oct 10, 2007
I suggest that patients who want to use this hospital right now should request their physicians to temporarily delay submitting their bill until the dispute between the hospital and the Blue Cross Plan is settled. That way, the physician can be reasonably sure to get paid, with probably only a modest delay. If there is a co-pay or deductible in your contract that you have to pay, offer to pay that right now while the unforunte dispute is still not settled.

Your physician is smart enough to know that the dispute will be settled soon, or ele that he will have to fiind another hospital in which to work and earn a living.

That is one way for the public to put pressure on these two public service organizations to expeditously settle matters in the public interest. Enlist the physician on the side of your heath, not allowing his money considerations to interfere with what he knows is needed.

If the physician won't agree to that, and won't seek another hospital staff apointment as she or he should to protect your heaalth and pocketbook, I would be very surprised.

In that case, I would wonder if maybe your physican is unable to meet the qualification requirements of other hospital medical staffs. Maybe you should be asking your physician for his referral to someone else on the hospital medical staff who is willing to delay billing you for a while.

In any case, don't allow this contract dispute to interfere with your health!
Lake County

Buffalo Grove, IL

#4 Oct 10, 2007
The hospital has been on a downhill slide since Millirons became President/CEO. This is just one more nightmare that can be chalked up to his ego and greed (and no, I am not on staff). There seemed to be enough money to hang his picture in every patient room, redo his office, complete with grandfather clock and flat screen tv and use limos for the trips to the airport. Just blink and get is over with; how long can a hospital survive with no patients?
County resident

Chicago, IL

#5 Oct 10, 2007
If Millirons is the problem, it is up to the Condell board of directors to decide whether to sack him. For sure, accountability starts at the top. The board also needs to decide whether the 12 story tower plan is even feasible, especially if a bunch of doctors are looking at leaving because their practices depend significantly on revenue streams from BC/BS. And if that's what the doctors are thinking about doing, what is happening at the nursing staff level???

The real question to me, a simple-minded MBA, is whether costs are being intentionally deferred in order to artificially inflate the bottom line in advance of a sale. Yes, matching is an accounting principle, but some stuff is just not reported clearly through annual reports.
Black and Blue

Indianapolis, IN

#6 Oct 11, 2007
I've been so badly beaten up by BCBS of Illinois about a doctor visit my wife had a year ago, that I will never choose to associate with BCBS of anywhere, ever again. Rather than go into all the convoluted details I will simply say...I just ended up paying the bill twice just to stop the pain. BCBS of Illinois is troubled, no doubt.
Concerned in Lake County

Northbrook, IL

#7 Oct 11, 2007
County resident, you are right about the board of directors. But from what I understand, someone will have to wake the board up and tell them what's going on.

Since Millirons has been there he's not only messed up the BC/BS deal, but the doctors are livid (ask one) and the staff is livid (ask about the many re-organizations, departures of key individuals, lack of communication on these issues and the addition of management layers while service continues to suffer).

Not to mention the deterioration of the relationship with local government (ask the Libertyville Board) and the worsening of already strained relationships with local residents, etc.- all the while the Condell Board has sat idly by.

If Millirons' and the Board's goal is to sell the hospital, they better act soon. At the rate they're going the price is going nowhere but down.
Jaze 08

North Chicago, IL

#8 Oct 11, 2007
I got folks down in your area.

I'm in the medical field and we as a country so rich in resources should not have a problem with providing quality health care to our citzens. Where are our priorities? We must demand change in the health care crisis.
Terry

Louisville, KY

#9 Oct 11, 2007
Specter wrote:
We need universal, single payor healthcare NOW! It's beyond time for change. These private insurance companies are driven by one thing -- profit. And in the process, the US healthcare system is still being held hostage, continuing its costly descent into the provervbial toilet. We are the only nation in the world with such an abominable private system, we spend more than any other country on medical care, and yet still, we have 40-50 million uninsured and our life expectancies and health outcomes trail those found in Eastern Europe. Disgraceful.
You are horribly misinformed regarding these issues. Universal healthcare is not a solution for America. You must have missed the section where the Hospitol raised it's rates 37%, while national trends are only 12%. The hospitol was getting greedy, not BCBS. Had the insurer agreed the would have been forced to increase premiums to make up the difference. While I'm not a fan of BCBS, the are correct in setting a tone to medical proffesional. Insurance companies (and thus policy holders) are not the means to solve your own financial trouble, and you cannot negotiate this way. Can you imagine what premiums would look like if every insurance company agreed to pay out 37% more every year? I'm sure you wouldn't like a 37% rate increase every year on your insurance bill
Johnson

United States

#10 Oct 11, 2007
Terry,

BCBS has had a relationship with Condell for decades now. This 37% that you reference seems very high but you forget that Condell has not had a rate increase comparable to other providers in the area. When Medicaid reimbursement is equivalent to what BCBS reimburses it raises red flags. Condell is also losing money for every BCBS patient it receives. BCBS is a bully with over a billion in profits last year.
Chuck Rogers

Salem, OH

#11 Oct 12, 2007
Just Wonderin what Resurrection feels about this as it sounds like Millirons is gearing up to sell and management staff coming in are from "Rez". Wonderin how much he's getting from underneath the table.
County resident

Chicago, IL

#12 Oct 15, 2007
Terry - looks like you could use more current information, too. Three guesses on who carries Condell's employee health insurance program. Yep, BC/BS is the major player.
Terry wrote:
<quoted text>
You are horribly misinformed regarding these issues. Universal healthcare is not a solution for America. You must have missed the section where the Hospitol raised it's rates 37%, while national trends are only 12%. The hospitol was getting greedy, not BCBS. Had the insurer agreed the would have been forced to increase premiums to make up the difference. While I'm not a fan of BCBS, the are correct in setting a tone to medical proffesional. Insurance companies (and thus policy holders) are not the means to solve your own financial trouble, and you cannot negotiate this way. Can you imagine what premiums would look like if every insurance company agreed to pay out 37% more every year? I'm sure you wouldn't like a 37% rate increase every year on your insurance bill
MadAsHell

Indianapolis, IN

#13 Oct 15, 2007
We just got the letter today from BCBS. We have been in the Federal PPO plan for quite some time now. I am so pissed right now I had to write. I just e-mailed Condell on the website to let them know how I feel.
Every member of my family has been a Condell patient for over the past 20 years. Myself admitted twice, my daughter was born there in 1999 and my husband had hip surgery in 2004.
And my OB-Gyne of 15 years has their offices inside Condell and at the Condell satellite in Gurnee.
We live 2 blocks from Victory Hospital in Waukegan, but we go to Condell because of better services, wait time etc, etc but now we are forced to either change our health insurance, or go to a different hospital!!!
Everyone needs to watch Michael Moore's Sicko movie. It is a real eye opener. I just saw it a few weeks ago, and now this happens to me. No one is safe.
Healthcare in this country needs to change dramatically!!!
Lake County resident

Louisville, KY

#14 Oct 17, 2007
BC/BS is the "former" carrier for the Condell employees, I believe that they moved over to one of the other carriers. The employees must have had enough of the BC/BS games themselves. They moved on and the hospital moved on. Makes you wonder how this will impact BC/BS's monopoly on healthcare going forward.
Heart Specialist

Northbrook, IL

#15 Oct 18, 2007
While BC/BS may have made "over a billion" last year, keep in mind they are a mutual (non-profit) organization that is, in effect, "owned" by the policyholders. And if they increase payments to Condell, they would likely have to add that increase to premiums - which would have a major impact to employers and employees alike. I know I would not want to have to absorb a 37% increase in premiums for my insurance.

Bottom line - both Condell and BC/BS leadership need to quit being so petty and get to the bargaining table and figure this out quickly, because it's having a major impact on health care in Lake County. Time for those high paid CEOs to earn those big salaries - come on guys!
Lake County resident

Louisville, KY

#16 Oct 18, 2007
Heart Specialist - wonder how much of 37%(or healthcare costs in general) is needed to cover related physician cost increases?

It's easy to call this a "petty" two-party dispute between the carrier and the hospital, when in reality it's a three party PROBLEM when you include the practitioners! Either way, the patient is in the middle....
Laurie K

King Of Prussia, PA

#17 Oct 18, 2007
"What does this mean, is Condell now taking back the doctors and leaving the patients with BLBS healthless"
Featured in todays Dailey Harold:

Blue Cross Blue Shield of Illinois has reinstated most of the 93 doctors affiliated with Condell Medical Center who were dropped from the insurance giant's PPO network last week.

The physicians were shut out because they had admitting privileges solely at the Libertyville hospital, which is no longer part of Blue Cross' network.

Condell ended its PPO contract with Blue Cross this month because the insurer stopped making advance payments for patient services in June. The move affects tens of thousands of Blue Cross PPO and HMO patients in Lake County, who would have to find new doctors.
Heart Specialist

Northbrook, IL

#18 Oct 19, 2007
Lake County Resident - less of the 37% goes to the doctors then you might imagine. Doctors have separate agreements with health care plans and bill patients seprately. In fact, the Blues have been targeted by a class action lawsuit for allegedly lowballing/delaying payments to doctors. Beginning to see a pattern here with the Blues?
http://www.bcbsil.com/PDF/thomas_love.pdf

But since you brought it up, we might as well drag the lawyers and politicians into this, too. Illinois has among the highest malpratice insurance rates in the country. Check it out. Costs more to be a doctor here.

At the end of the day, this is a dispute between Condell and BC/BS - who both refuse to negotiate at this point, preferring to play the "spin" game in the press while thousands of people try to figure out their next steps.
north shore resident

Skokie, IL

#19 Oct 31, 2007
BCBS has been one of the best insurance carriers, providing prompt payments,great coverage and quality physicians. I would question if the issue lies deeper than what meets the eye or the press. Think about it. Why would they drop those physicians only on staff at Condell? Maybe there is an issue in quality of care? Maybe there are revenue boosting practices for the hospital and certain physicians that are not in practice at other hospitals. BCBS is not out to hurt the patients. There are plenty of qualified physicians everywhere that are covered by BCBS. I don't think anyone knows the full story.
County of Lake Resident

Chicago, IL

#20 Nov 4, 2007
Found this site on google. A comparison of charges conducted by a non-for-profit organization found that “Condell Medical Center (Libertyville, IL) charges 392% times its costs. That is 316% times what Johns Hopkins charges!”

http://hospitalvictims.com/hv_hosp_anc.asp...

http://hospitalvictims.com/hv_hosp_main.asp...

http://hospitalvictims.com/hv_hosp_total.asp...

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