Health providers clash on insurance deal

By Dave Frank

Appeal Staff Writer

A Carson hospital's insurance deal will hurt patient care and choice, according to a competing specialist. The hospital, however, says patients will get better and cheaper care under the agreement.

The exclusive contract Carson Tahoe Regional Medical Center signed with insurance company Hometown Health in March will let it provide non-emergency imaging work such as X-rays and MRIs for the insurance customers.

Great Basin Imaging, however, says that it does the majority of this kind of work in Carson City. Giving the hospital the right to do all the imaging creates a monopoly that will create higher prices and poorer care for patients affected by the deal, the imaging company maintains.

About one-fifth of Great Basin's customers have Hometown Health insurance plans. Great Basin did about 3,700 procedures last year from those customers that have Hometown Health insurance, representatives say.

But, by the time the contract takes effect in September, Carson Tahoe will provide better imaging services at a better price to customers, said Cheri Glockner, a representative for the hospital.

The insurance company, part of Reno-based Renown Health, and the hospital, have been negotiating for four years, she said, and are excited to give the best service to patients, who include hundreds of state employees with the Public Employees' Benefits Program.

The insurer said this in a statement:

"Hometown Health strives to provide members the best access for the best price ... This agreement helps Hometown Health keep premiums manageable, and participants will see lower out-of-pocket costs for imaging services at Carson Tahoe Regional Medical Center."

The agreement, however, is taking away these patients' right to choose the best imaging specialist in the city, said Steve Mims, administrator for Great Basin.

The hospital is not able to compete with Great Basin's service, he said, so it is instead "backdooring" the competition.

David Landis, a doctor Great Basin, said they hadn't ruled out legal action against the hospital.

"We keep coming back to what is best for the patient," he said.

Both Landis and Mims said the hospital wouldn't be able to make such a deal with Hometown Health if Nevada had what is called an "any willing provider" law. This would require insurers to contract with any certified medical provider.

The state needs this kind of law to avoid pitting providers against each other, said Bonnie Parnell, a State Assembly member from Carson City.

"My concern is that the last thing we want to do is deny patients choice and access."

At least five states have these kind of laws. Two others had the laws, but courts overturned them.

Great Basin representatives said they plan to appeal to the board of the Public Employees' Benefits Program on June 5.

• Contact reporter Dave Frank at dfrank@nevadaappeal.com or 881-1212.

If you go:

What: The Public Employees' Benefits Program board meeting

When: 9:30 a.m., June 5

Where: Legislative Building, 401 S. Carson St.