Patients…and the Renegotiation of Health Care

Negotiations between Blue Cross/Blue Shield of Massachusetts and Tufts Medical Center made news this week: Tufts wants what it considers to be a modest increase in payment rates over the next three-to-five years. Blue Cross says that Tufts is already making too much. Tufts says that it gets paid at lower rates than other, larger providers. Blue Cross says… You get the picture. They are at an impasse.

Blue Cross has threatened to walk away: it has sent a letter to approximately 80,000 subscribers telling them to prepare to find a new doctor if a deal is not reached by mid-January, 2012.

It is interesting that we laid out a similar scenario in the fictional “novel” that runs through Renegotiating Health Care. The tensions between payers and providers are only going to get more intense given the state of the economy, the aging of the population, and the continued rise in chronic disease rates. It will be a hotbed of conflict resolution or, if we are lucky, collaboration and multi-dimensional problem solving.

Our first thought upon reading about the situation in Massachusetts was to think about the patients. How different a negotiation this would be if patients were at the table. What innovative possibilities might emerge if the negotiation evolved from “us against them” to the pursuit of a new reality in which each party felt it emerged a winner? Bringing all of the stakeholders into the discussion is the best way to move from “pain-pain” to “gain-gain” negotiation.

We were interviewed on the topic by Boston NPR affiliate WBUR. Their CommonHealth blog does great coverage of the local health scene and, because healthcare is so central to Boston, the reports often cover issues of national significance. Acrimonious negotiations like those reported here are likely to play out again and again across the country in the years ahead. We hope that they turn out as positively as they do in our book.


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