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health care

Health insurers respond to OHIC’s survey


PROVIDENCE – How did the three commercial health insurers in Rhode Island respond to criticism from a survey of Rhode Island medical providers?

The survey, conducted by the R.I. Office of the Health Insurance Commissioner, found that there was general unhappiness regarding issues of fair treatment of providers, promotion of affordability and quality of health care, according to the survey results released on Feb. 15.

Blue Cross & Blue Shield of Rhode Island, the largest commercial health insurer in Rhode Island with 397,000 covered lives [the technical term to measure customers], responded by saying: “We have no further comment at this time.” Providers said in general that they were more satisfied with Blue Cross than with the other health insurers’ performance, according to survey results.

Tufts Health Plan of Rhode Island, with the smallest market share, with only 15,000 covered lives, said that they would use the results of the survey “constructively” to improve its services and relationships with providers. “We will continue to work collaboratively with Rhode Island providers on our shared commitment to nationally recognized, high-quality care,” said Sonya Hagopian, Tufts’ vice president of corporate communications and public relations. The survey found that provider satisfaction with Tufts varied across the metrics, with a higher percentage of respondents satisfied with rate adequacy and claims processing accuracy and simplicity, but providers were unsatisfied with additional payments and delivery system improvements.

Providers were generally dissatisfied with UnitedHealthcare of New England, the second-largest commercial health insurer with 147,000 covered lives, with more than 54 percent of respondents indicating ‘poor’ or ‘very poor performance in most categories, according to the survey’s findings.

United offered no response specifically tied to the Rhode Island survey’s findings. Instead, Ben Goldstein, public relations director for UnitedHealthcare, responded by saying: “I believe UnitedHealthcare has cultivated much improved relationships with care providers, and has worked hard to do so over the last several years.” Goldstein cited as evidence “tens of thousands of telephonic surveys completed” that showed physicians and their office staff reported a 91.7 percent satisfaction rate with UnitedHealthcare. In response to a question about who had conducted the surveys, Goldstein explained “the telephone surveys were optional, automated surveys that care providers chose to participate in” after they completed their call with a customer service representative.


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