| The skinny
During a fireside chat at the Medicarians Conference in Las Vegas on Tuesday, SCAN Health Plan CEO Sachin Jain made a plea to brokers: Drop the for-profit plans that treat you poorly and seek not-for-profit partners. However, one broker in the crowd noted that sometimes they don’t have a choice. Jain’s plea
The comments came after the Centers for Medicare and Medicaid Services announced this month a final Medicare Advantage rate increase of 2.48%, which is really more of a “rate cut” when inflation is higher than 2.48%, according to Jain. This will lead to plans exiting markets and suspending broker commissions, while not-for-profit plans like SCAN haven’t “monkeyed around with people's commissions,” he added. Oftentimes, even when a for-profit plan exits a market and cuts broker commissions, brokers still keep going back to that same plan, Jain declared. “The number of folks who are like, ‘So and so is my friend at such and such plan, so I'm going to keep working with them even though they're messing with me.’ Forget it, really pay attention to who they are and how they treat you and don't go back. What would you tell a friend who's like, ‘I borrowed this money from you … and I'm not going to pay you for it?’ You would say ‘F off.’ You should be thinking about why it is that you want to keep doing business with people who show you exactly who they are and it's not pretty,” he said. The broker’s response
An independent broker in the crowd, Julia Cooke, had a visceral reaction to this comment, stating that the reason they keep going back to these plans is because they also “own the doctors.” In an interview after the session, Cooke explained that when a company — like UnitedHealth Group — owns an insurance plan, a pharmacy benefit manager and the healthcare providers, they’re too dominant not to work with. She noted that where she lives in Snohomish County, Washington, UnitedHealth Group owns 40% of primary care. Sometimes brokers have to work with plans that treat them poorly because the client’s choice in provider overrules everything else. — By Marissa Plescia |
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