Power struggle: Doctors get mixed results in HMO fight

When a Utah group took on the state's dominant HMO, it learned that their leverage was limited, and that victory comes where you can get it.

By Myrle Croasdale, AMNews staff. Dec. 3, 2001.

If you've ever wondered, "Why do I keep signing these HMO contracts without a fight," consider the case of Ogden Orthopedic and Neurosurgical Specialists.

If anyone would seem to have negotiating leverage, it would be this Utah group. They represented 15 out of 16 surgeons in their specialties in the Ogden area.

The physician group says payments from the Salt Lake City-based Intermountain Health Care have been virtually halved since 1992; fed-up, they decided to hold out for a 38% increase, rather than the 4% Intermountain offered. The physicians also wanted no part in a newly devised risk-based contract. When they didn't get what they wanted, the Ogden group quit Intermountain, thinking that would get management's attention.

It did.

Intermountain executives then refused to talk with the physicians. The health plan ran negative ads against the group, and it began a search to hire doctors to replace them.

After several months of no progress and falling revenue, three of the 15 physicians returned to the HMO.

Those sticking it out have one last hope. Along with 100 of the 130 or so orthopedists in Utah, they joined the Federation of Physicians and Dentists, a physician union. The Ogden group is hoping that public pressure generated from this fight will help them get what they want from Intermountain.

It all started roughly a year ago, when Intermountain was renewing contracts with physicians, said Jack Crosland, MD, an orthopedist who has represented the group of 11 orthopedists and four neurosurgeons in discussions with the health plan. [...]