AAMC–CareFirst Stalemate Places Our Healthcare in Jeopardy

Citizens Need to Speak Out; State and Local Government Need to Intervene

AAMC–CareFirst Stalemate Places Our Healthcare in Jeopardy
Anne Arundel Medical Center

On July 14, Anne Arundel Medical Center (AAMC) sent a letter notifying the health insurance provider CareFirst of its intent to terminate their contract on September 30, 2017.

If an agreement is not reached, as of October 1, everyone insured by CareFirst will be treated as out-of-network patients for AAMC’s outpatient services, including all Anne Arundel Medical Group practices, Anne Arundel Diagnostics Imaging, and Pathways, AAMC’s treatment center for drug and alcohol abuse. Moreover, beginning January 1, 2018, CareFirst members will be out-of-network patients for all other AAMC services. According to the medical center: “If your health plan does not include out-of-network benefits, you will not be covered for services that we provide.” This leaves patients with the entire bill to pay.

CareFirst is the largest provider of health insurance in Anne Arundel County, and AAMC is the county’s largest provider of healthcare. Some 30,000 county employees and their dependents rely on CareFirst for health insurance and on AAMC for their healthcare. In addition, thousands of other county residents, including many federal employees, depend on the two organizations. If a deal isn’t reached, everyone with CareFirst insurance will be forced to pay higher out-of-pocket medical expenses, which they may not be able to afford. They may also be forced to find new doctors and medical services, which may not be available in our area. The health and financial security of tens of thousands of Marylanders is therefore at stake in this dispute.

AAMC claims that CareFirst “unilaterally decreased the amount of money it pays for services at Anne Arundel Diagnostic Imaging and care at Pathways.” The medical provider wants to see the rates restored to their previous levels. But CareFirst claims that “the medical center is asking for an increase in fees that the insurer considers unjustifiable.”

I do not know who is right and who is wrong in this dispute, but frankly who is right and who is wrong is beside the point. What is important is that we, as citizens, cannot allow any healthcare provider or insurer to gamble with our well-being in any negotiation. Moreover, the additional costs or revenues that AAMC and CareFirst are squabbling over cannot possibly justify putting our lives in jeopardy.

Both AAMC and CareFirst are not-for-profit organizations. According to AAMC, “as a not-for-profit, community-based hospital, Anne Arundel Medical Center holds itself accountable to the people we serve—you.” CareFirst claims that its mission is to “provide affordable and accessible health insurance to the plan’s insured and those persons insured or issued health benefit plans by affiliates or subsidiaries of the plan.” Both parties’ refusal to reach an agreement belies their missions.

Moreover, neither AAMC nor CareFirst is in financial jeopardy. Both certainly can afford to compensate their CEOs well. AAMC’s CEO, Victoria Bayless, was given a compensation and benefits package totaling $880,780 in 2012, the last year for which I could find information. Chet Burrell, CareFirst’s CEO, received a package totaling $2,515,272 in 2013.

Call to Action

Citizens need to contact our local representatives and tell them that under no circumstances can we allow AAMC to drop CareFirst as an insurance provider. Moreover, we must insist on better regulation of health insurance and health care in Maryland, so that no insurance company or healthcare provider has the ability to jeopardize our lives and financial security. Please contact Steve Schuh, Anne Arundel County Executive, as well as your district county councilman, state senator, and state delegate. Finally, go on social media to urge CareFirst and AAMC to put their patients’ needs first, as they promise in their mission statements.

I’ve heard from people who have already contacted local representatives. Generally, the response has been that there isn’t much they can do. We need to tell these representatives that if they think they have no control over the situation, then they need to take a closer look at how the health insurance and healthcare markets are regulated in this county and state. The system is failing us if we can do nothing to prevent AAMC and CareFirst from recklessly cutting off our access to quality healthcare.

For more information, read the Capital Gazette articles “Anne Arundel Medical Center May Drop CareFirst Insurance” and “CareFirst Puts Price Tag on Dispute with Anne Arundel Medical Center,” connect with the Anne Arundel County Chapter Healthcare is a Human Right Facebook page, and attend the Annapolis Healthcare Rally on July 29 beginning at 10am in Lawyer’s Mall.

The Big Picture

The stalemate between AAMC and CareFirst is just one example of what can go wrong in the absence of a well-run healthcare system that is regulated to meet citizens’ needs. The current debate in Congress on this issue, in which the care of millions is at stake under the Republican plan, underscores the exigency. We need to demand a fair and just healthcare system in which everyone who lives in the United States has access to high-quality healthcare.

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