Dan Gottry - Blog

Dan Gottry's Blog

Friday, September 15, 2006

Provider Seeks to Provide "Ammunition"

Hey Dan,

I am fully supportive of what you are trying to do here. Grassroots from patients, particularly the Cigna patients, is probably the only way to correct this. I'd like to give you some more ammunition, but must do so in confidence for reasons I won't go into.

The phrase "cost-effective healthcare" came up a number of times in Cigna's communications. It might interest you to know that the contract Linkia negotiated was absurdly low, lower than most state Medicaid reimbursements. I'm sure you've heard all the buzz about the compromised quality of free healthcare. Well, the premiums you're paying Cigna for will buy you care that is reimbursed at an even lower rate than the free stuff in many instances. The rates are so low that one Hanger office manager, only partially joking, asked his local Cigna case worker how he could reduce the number of Cigna referrals that were sent his way. These Hanger clinicians will likely have a hard time finding any profit margin given what they are being reimbursed, and the temptation to compromise care in reduced follow-up care, or less expensive componentry will certainly be present.

Your Burger King analogy wasn't far off. Hanger clinicians are "strongly encouraged" to not use other, higher priced items. The extent of this "encouragement" has caused many clinicians to leave, the organization. You might also find it interesting to know that it is quite rare for a Hanger clinician to attend the annual educational meetings of the American Academy of Orthotics and Prosthetics. Instead, they all attend their own, Hanger Education Fair, where they are presented with only the technology and subject matter that Hanger invites to attend and where as much time is spent on maximizing profits as on enhancing patient outcomes.

So you have every right to be concerned. There are some good clinicians within that organization, but there are some bad ones as well. And for the most part, patients will only have one office within reach as Hanger operates quite efficiently in this regard.

The serpent has many heads. If you can cut of one of them with this Cigna-Linkia fiasco that saves Cigna a bunch of money, gives Hanger something to show their stock holders and compromises the quality of care for all policy holders, I wish you the best.

posted by Daniel Gottry at 7:50 AM