Physicians, Plan at Odds Over Autoworker Coverage

Physicians in Michigan are angry and vow that they’re not going to take it any more. The Michigan State Medical Society and the Michigan Osteopathic Association are suing Blue Cross Blue Shield of Michigan after the health insurer cut

500 doctors from its provider network. That is about 5 percent of the physicians in the plan networks that serve the Big Three automakers, whose concern about the rising cost of health care prompted the insurer to make the move.

In the meantime, an additional 1,900 doctors quit voluntarily after the plan announced that it would reduce payments for a range of medical services, the Wall Street Journal reports. “They are trying to whittle away at the amount we can charge by forcing us to charge what they want us to,” Betty Chu, MD, a gynecologist in Clarkston, Mich., tells the newspaper.

Robert J. Stomel, DO, the MOA’s president-elect, says that the health insurer and the Big Three “believe they can force physicians to discount their fees without input as to how these arbitrary conditions may affect access of UAW members and their families to physicians of their choice.”

But Lisa DeMoss, the senior vice president and general counsel for the insurer, indicates that physician performance is being used to decrease the ranks of the provider networks, saying that the plan “included some practitioners with less cost-effective patterns of care.” She tells the Wall Street Journal: “Cost is an issue for all purchasers of health care products today. To the extent that you have a product that is not performing up to expectations, nobody is going to buy it.”

This is the latest salvo in the Big Three’s battle to cut the costs of health care. “We’re pretty tough on how we purchase health care and despite that, our costs are going up a lot,” John Devine, GM vice chairman and CEO, tells the WSJ.


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015

Our other journal

P&T Journal for September 2014



Legal Risk Management Opportunities, Pharmacy Practice, and P&T Committees

Hospitals Struggle With ACA Challenges

Drug–Gene Interactions: Inherent Variability in Drug Maintenance Dose Requirements

Schizophrenia: Overview and Treatment Options


Schizophrenia Therapy Options Increasing



Too Many Abandon the “Second Victims” of Medical Errors


New Controversy for 340B: OPA Rebuffs Ruling by Court

New Drugs/Drug News/New Medical Devices

Pharmaceutical Approval Update


Loxapine Inhalation Powder (Adasuve)

Our most popular topics on