Representatives from the Wyoming Medical Society, as well as the Cigna
and the community discuss rising healthcare costs during a dinner
in Cheyenne on March 15.
Crowd of Business Owners, Healthcare Representatives, WMS Discuss Cost
By Tom Lacock – Wyoming Medical Society
CHEYENNE – A crowd of 47 physicians, employers, Cigna representatives, and representatives of the state broke bread March 14 at Little America in Cheyenne. On the agenda was time to talk specifically to Laramie County providers about re-contracting by Cigna, as well as time for a larger discussion about healthcare costs in Wyoming.
The evening was kicked off with a presentation by Cigna to a smaller group of Laramie County-based physicians. The discussion offered an overview of Cigna and why the firm feels it needs to address the re-contracting process. More specifically, Cigna said it is trying to bid on the state employees insurance contract in May and has been asked by the state to keep its costs from continuing to rise. Among the methods they are using to do this is cuts to provider reimbursements, which were announced last month in a letter sent to providers in Natrona, Laramie, and Albany Counties. The physicians in the crowd expressed their frustration with the level of cuts and the process by which Cigna announced the reimbursement changes.
The second half of the meeting featured a panel discussion to talk about reasons for the rising costs in healthcare. The panel, which was moderated by Cigna Mountain States President Kim Bimestefer, included: Scott Dishing (Senior Director of Corporate Relations for the American Cancer Society); Dr. Jim Bush (State Medicaid Medical Director); Ralph Hayes (State of Wyoming); and Wyoming Medical Society Vice President Paul Johnson, MD.
Each panelist offered an overview of healthcare in Wyoming. Dishing suggested Wyoming’s high tobacco usage (23 percent) numbers and the national trend of a 300 percent increase in childhood obesity since 1980 is taking its toll on healthcare costs.
Hayes told the crowd the State of Wyoming plan is self-funded, which he said means each time a claim is put forth to Cigna by a state employee the money comes straight from the state. Johnson suggested if the state wanted to cut costs, it should consider both changes to non-economic damages, as well as Medicaid expansion. Johnson pointed out the differences in medical malpractice costs between states without tort reform and those with, showing some annual premiums are over 140 percent more expensive for Wyoming providers than for out-of-state doctors.
“Physicians aren’t getting paid any more than they used to,” he said. “Reimbursement is not going up. That is an area that is staying the same if not shrinking. Our costs are rising however.”
Other cost drivers discussed included early cancer screenings, as well as Wyoming Medicaid’s efforts to use coordinated care such as PCMH to keep readmission rates into the ICU to just 6 percent in the Cowboy State, compared to 18 percent nationwide. Bush also mentioned the need to treat the co-morbidity of substance abuse and mental illness, which he said leads to significantly higher costs to the state.
Bimefester said Cigna will offer its services to the State of Wyoming to help it apply for a State Innovation Grant through CMS to address concerns with mental health and grow other services in Wyoming. She also mentioned a concern for seeing $70 million in medical care dollars leaving the state due to patient out-migration. She said healthcare delivery is cheaper for Cigna when it is delivered closer to home. She also encouraged self-funded employers to partner with non-profits, such as the American Cancer Society, for initiatives such as cancer screening.
Other topics discussed included telehealth, with Bush pointing out the state is moving forward with a new telehealth platform. Bimefester said Cigna likes the cost of telehealth, which she said is adaptable to millennials, when appropriate, but they prefer to find ways to create a better patient-physician relationship with primary care such as in-person appointments.
Similar meetings will be held in Casper and Laramie in April. The Casper meeting date is still being determined with the Laramie meeting being scheduled for 5:30 p.m. April 7 at the Rochelle Gateway Center on the University of Wyoming Campus.