Curmudgeon's Corner
cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner
Healthcare Consolidation & Collateral Damage...
The phrase 'collateral damage' is most often associated with military battles when things adjacent to a target get 'broken'.
There is the potential for collateral damage in the world of healthcare, and we see that playing out today between Aurora, Wisconsin Physician's Service (WPS), Health EOS, and employers and employees. As Aurora has managed to acquire and/or merge its way to the size that it is, it has become a very dominant healthcare entity. It participates in networks (as well as stand-alone relationships), and network access is sold by Health EOS among others. Health EOS, a preferred provider organization, is the product of consolidation/acquisition, as well.
WPS and Aurora have been involved in a legal battle for some time now, and some of that 'battle' has leached into what we might call the very real world of day-to-day healthcare. An earlier suit between the two entities was settled in early 2007. WPS brought a new suit naming both Aurora and Health EOS in mid-January claiming that Aurora was interfering with WPS in its contract with Health EOS.
WPS is claiming that Aurora has asked that Health EOS not permit WPS patients' access to the Aurora hospitals and physicians at the preferred pricing that has been negotiated between Health EOS and Aurora. WPS has a contract with the employer, Milwaukee County in this instance, that provides for County employees and their dependents to use the Health EOS network of which Aurora is a part.
When the elephants of the new consolidated healthcare world dance, employers and employees and dependents can be 'trampled'.
We all understood that legal issues tend to play out over a lengthy period of time as each side works with its attorneys and the legal system. An Aurora or a WPS can sustain this lengthy legal maneuvering, but the covered employee needs the care today or tomorrow. You can imagine how disconcerting these news items are to those who wonder if they're going to be covered and, if so, at what price. The union leaders and the employers involved become very concerned because their telephones are going crazy with calls from the members/employees.
As healthcare consolidation continues, there are fewer, but larger organizations left in the wake. If we get down to a couple of major healthcare organizations, the choices that used to exist become severely limited. Collateral damage seems bound to occur more often and/or with more severity in that new world as the 'elephants' parry and thrust to gain market share, acquire the few remaining independent targets, and so on.
It is one thing when large companies struggle with each other in the competitive marketplace, but entirely another when we see the patients caught between. We talk of unintended consequences often; this is one of those. This outcome may have been thought about but it was not the desired result. Yet, it can hurt people just the same as it would had it been intended.


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