Top private insurer to make reimbursement cuts - - The News for South Mississippi

Top private insurer to make reimbursement cuts

JACKSON, MS (Mississippi News Now) -

The state's largest private insurance provider is about to make cuts to how much reimbursement money is paid out to healthcare providers.

Blue Cross Blue Shield of Mississippi is expected to make those cuts effective Wednesday.

"These cuts are designed to better manage the delivery and the quality of healthcare in Mississippi," said Communications Director John Sewell.

Providers affected will mainly be those in radiology and pathology, through reimbursement cuts for certain medical procedures. Sewell says with changes in the medical arena the company is trying to combat financial hurdles.

"There's an ever increasing need to insure the quality and medical necessity of healthcare services. That especially impacts the management of costs around those healthcare services," said Sewell.

"It's not a chicken and an egg where they start at a 50 percent cut and hope for 25. This is an actually problem that the insurance companies are having and they're looking at reimbursement rates," said Mississippi Insurance Commissioner Mike Chaney.

While the department of insurance doesn't typically get involved in network payout cases, Chaney says his office is working as a facilitator.

"The problem is that most companies are facing some tremendous pressure on the cost and to hold cost down they're reducing the payments that they make to the providers," said Chaney.

By reducing those payments, Chaney says consumers will most likely have to eventually pay more. Some physicians are concerned it will all hurt the state's medical climate while Chaney says companies and states around the region are battling the same problem.

"We're not the only state in this boat. Alabama is in the same boat we're in. Louisiana, Tennessee, Arkansas, Texas, Florida, Georgia, we're all in the same boat and we're all working to try to have a common solution to make things work," said Chaney.

There are talks going on between physicians and Blue Cross Blue Shield to see if anything can be worked out. The procedures set to receive reimbursement cuts are part of private legal contracts between the two parties.

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