'The Spirit of the Law'
Top executives at several of the hospitals excluded from Anthem Pathway are chafing under a provision of the law that allows exchange health plans to require patients to travel as far as 90 miles for services.
COO, Upper Connecticut Valley Hospital
"I don't think people should be bullied into driving an hour to get their health care," said Peter Wright, president and CEO of Valley Regional Hospital in Claremont, NH. "They created a product that maximized the value to their investors. Anthem didn't follow the spirit of the law."
Wright said being left out of Anthem Pathway poses significant transportation hardships for patients in Claremont, which is among the most disadvantaged communities in the state. "We have to make a choice of what's more important: maximizing an insurance company's profits or providing access to affordable health care to the residents of New Hampshire who need it," he said.
Charles White, COO of Upper Connecticut Valley Hospital in Colebrook, NH, said he suspects Anthem avoided economically challenged communities when it designed its narrow network. "The most disadvantaged hospitals were red-lined out of the network," he said, noting UCVH would have accepted Anthem Pathway's relatively low reimbursement rates because the hospital relies on commercially insured patients to remain economically viable. "We would have taken the product even though it would have hurt us financially."