Patients enrolled in Anthem Blue Cross of California may be in for a rude and costly awakening the next time they visit a physical therapist: according to the California Physical Therapy Association, Sacramento, Calif, the insurance company is slashing payment for physical therapy services to a rate so low it is financially impossible for many physical therapists to continue providing care to enrollees of Anthem Blue Cross, the organization said in a statement.
"Physical therapists are concerned that Anthem’s dramatic and unilateral reduction in payment will have a substantial effect on the quality of care being provided and the ability of many therapists to continue to participate in Anthem’s network," said Cheryl Resnik, PT, CPTA president, in the statement "We find it unreasonable for Anthem Blue Cross to jeopardize the treatment of its enrollees by choosing to make such a drastic policy change. We are asking them to reconsider, but they have not indicated that they are willing to do so. Physical therapists attempting to negotiate their rates with Anthem have been met with a ‘take-it-or-leave-it’ response from the carrier."
Communications sent to providers indicate that effective March 1, 2010, Anthem Blue Cross will modify the current payment policy to an unreasonable capitated rate per visit., the organization said. When that goes into effect, physical therapists will experience up to a 50% reduction in payment for all treatment regardless of the intensity, duration, or degree of care provided. This severe rate cut, coupled with rising practice expense costs, will make it financially impossible for many providers to offer care to Anthem Blue Cross enrollees under this arrangement, the organization said. While Anthem is asking its subscribers to accept a 39% increase, it is cutting the rate of payment for the services provided by rehabilitation specialists, according to the organization.
"By lowering the boom, Anthem’s proposed action will likely have a substantial impact on its beneficiaries, especially those most vulnerable," said Stacy DeFoe, executive director, CPTA. "It is difficult to imagine that this move will not detrimentally affect access to care to the full realm of rehabilitative and wellness services provided by physical therapists. It could also delay the resolution of many patients’ conditions."
[Source: California Physical Therapy Association]