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California physicians oppose health plan mega-mergers



March 28, 2016
Area(s) of Interest: Advocacy Commercial Payors Payor Issues and Reimbursement 

SACRAMENTO — Eighty-five percent of California’s physicians are opposed to the merger of health insurance giants Anthem and Cigna, according to a new analysis released by the California Medical Association (CMA) on Monday.


The CMA survey, conducted in collaboration with the American Medical Association (AMA), sought to gauge California physicians’ perspective on the proposed Anthem-Cigna and Aetna-Humana mergers, as well as gather insight into the tactics undertaken by insurance companies’ in their negotiations with physicians.


“California’s doctors could not be more clear: these mergers are bad for patients and bad for medicine,” said CMA President Steven E. Larson, M.D. “These two mergers would give insurance companies near monopsony at the expense of patients’ access to providers and physicians’ ability to provide fundamental care. In the end, patients will suffer.”


The survey results were released on the eve of a California Department of Insurance hearing on the implications of the proposed Anthem-Cigna merger. Both CMA and AMA will be testifying in opposition to the merger at the hearing.


Concerns over consequences of this type of market consolidation included narrower physician networks that make it more difficult for patients to find care from in-network physicians (82.2%), reduced ability for physicians to advocate on behalf of their patients (81.9%), and a reduction in the quantity or quality of services that physicians can offer their patients (88.8%). Physicians expressed similar concerns over the Aetna-Humana merger.


“If these mergers go through, the impact on everyday people trying to receive medical care in a timely and affordable manner would be devastating,” said CMA General Counsel and Senior Vice President Francisco Silva. “The result would be less competition with only the health insurers coming out winners.”


CMA has long been concerned with the consolidation of health plans and health insurers and the reduction of competition. When market power is consolidated among just a few plans, insurers contract with fewer physicians, limiting choice for patients, increasing wait times for referrals, and sometimes forcing them to pay more to see out-of-network doctors. Physicians across the country worry that the hardball tactics undertaken by these plans demonstrate that they put profits before patients.


The survey gathered data from 989 practices in 47 California counties, representing physicians from a range of specialties and practice sizes.


The DOI hearing can be live streamed here.

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