BUSINESSWellPoint is savvy but ... doctors are waryWellPoint Health Networks has flourished by leading the way in developing health plans patients want -- but physicians say the health care company isn't as friendly to them.By Julie Jacob, amednews staff. Sept. 3, 2001. At a time when many managed care companies are losing money and rethinking capitation, health care analysts point to WellPoint Health Networks as the industry leader that has broken from the pack. WellPoint, analysts say, stands out from the crowd because it consistently makes a profit and is well ahead of the curve in providing the flexibility and choice that consumers want from their health plans. Physicians, however, are less enamored of the company Fortune named the most admired health care company and wonder whether its success has come at the expense of physicians. They say WellPoint is no better than other companies and in some cases worse than others when it comes to payment rates and managed care red tape. For example, Ray Stricker, MD, a hematologist in San Francisco, dropped his contract with Blue Cross of California, a WellPoint plan, about a year ago, because he was frustrated with the low reimbursement rates and restrictive contract clauses. "Blue Cross had the worst reimbursement out of all the major managed care plans," said Dr. Stricker. "Their attitude with physicians is far less amiable than their relationship with investors," said Jack Lewin, MD, CEO of the California Medical Assn. WellPoint is named in three lawsuits filed in recent years by the California Medical Assn. -- two in conjunction with other HMOs and one, regarding physician reimbursement rates, filed against WellPoint alone. Dr. Lewin said physicians' biggest frustrations with the company were its "arrogance and administrative hassles."
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Copyright 2001 American Medical Association. All rights reserved.
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