This article first appeared in the St. Louis Beacon: An executive at BJC HealthCare said Friday that some patients enrolling in Missouri’s insurance exchange will be able to get health services from its affiliates through an agreement between the hospital system and Conventry Health Inc. That means the patients will have access to medical treatment from doctors and other providers in the BJC network, said June Fowler, vice president of corporate and public communications.
The announcement that Coventry was the second insurer that will take part in Missouri’s exchange came from Matt Wiggins, spokesperson for Coventry. He confirmed the arrangement in an interview Friday afternoon but had no immediate data on the plan or plans that will be offered in the Coventry program. The company was recently acquired by Aetna.
Initially, it appeared to some that BJC HealthCare would be out of the picture after Athem disclosed on Wednesday that it was excluding the hospital system from its exchange network. Earlier on Friday, Fowler responded to the issue by noting that Anthem was one of two networks that will be offering care under Missouri’s exchange. But she did not identify Coventry as the second insurer.
Fowler had also said the reaction to Anthem’s decision in the community and inside BJC was “disappointment that a network that would be established doesn’t include some hospitals that are a key part of the regional safety net. The way the exchanges work is that people make a choice of who they choose to secure coverage.”
She then said “we are confident that there will be a choice that includes the BJC hospitals. So that will mean you will have access to Barnes-Jewish, to Christian, to Children’s, to Missouri Baptist.” The BJC network includes 13 hospitals in the region.
The issue may be moot now that BJC is part of the Coventry program. Nothing definitive can be said, however, until consumers are able to make side-by-side comparisons of various health plans offered by the two insurers. The marketplace opens its doors on Tuesday.
Ryan Barker, vice president for health policy at the Missouri Foundation for Health, had commented on the BJC issue Thursday evening during a health reform presentation at the Kirkwood Community Center. Though saying Anthem’s decision raised concerns, Barker added that the public should wait for more information before making judgments. Coventry’s announcement bodes well for health consumers planning to use the exchange who want acce.
During his presentation in Kirkwood, Barker praised the Affordable Care Act and the promise of the new exchange system, saying these and other initiatives are aimed at bringing more efficiency and access to the health-care system. The two most important terms in health care, he said were morbidity and mortality.
“We’re very good at mortality,” he says, “good at keeping people alive a week, month, a year. Morbidity is about keeping people healthy, and we are not good at that in this country. We wait till people get sick then treat them instead of preventing diseases from happening.”
The latter approach, keeping people healthy, is the big goal of ACA, he says.
“The law really tries to shift the health care system in this country, which is not very easy. A lot of people don’t want to see it shifted. They make a lot of money on treatment instead of prevention. But prevention is the key. It’s also the key to controlling some of our health care cost.”
