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Physicians: Profit Lies With Intermountain Health Care

Posted on: Friday, 4 November 2005, 09:00 CST

By Paul Beebe, The Salt Lake Tribune

Nov. 4--A group of Utah doctors, saying Intermountain Health Care's control of the state's health care market is curbing doctors' ability to attract patients and operate profitably, is asking lawmakers to make it easier for them to join IHC's physician panels.

Physician panels are groups of doctors that have contracts with insurers to treat patients. Doctors who aren't on a panel, especially those affiliated with IHC, can have a hard time getting enough patients to sustain a practice, the physicians said. During the 2004 legislative session, lawmakers defeated a willing-provider bill to open panels to more doctors. A second effort passed the Utah Senate earlier this year but died in the House, leaving many doctors with only limited ability to win new patients.

"I would like to see more access. Any 'willing-provider' law would benefit us and help to make the playing field more level," said Terry Finlayson, a Logan orthopedic surgeon who was one of six doctors venting their frustrations at a meeting of a legislative task force exploring IHC's business practices. The meeting at the Capitol lasted more than three hours.

Paul Winterton, a Salt Lake surgeon, said he was "met with a slap in the face" when he tried to join several panels after moving to Utah six years ago.

"I was met with zero interest," Winterton said. "I was told that we are restricting the number of doctors on our panels."

Winterton said physician panels are overturning the relationships many doctors have with their patients. As cash-strapped employers move from one insurance plan to another to save money, their employees often are unable to continue to see the same doctor, he said.

"We are here to represent something that has gone horribly awry," Winterton told the 15-member Privately Owned Health Care Organization Task Force. "We see as doctors a health care management system creating enmity between patients and doctors."

Linda Leckman, chief executive of IHC's physician group, said IHC doesn't oppose willing-provider legislation. But she warned lawmakers that bigger panels would increase the cost of health coverage to employers, which in turn could lead to more people without health insurance. She said smaller panels, which might not offer as many services as a larger panel, are more likely to offer price discounts to insurers who can pass the savings on to employers.

"The most important thing is the size of the panel. Bigger panels mean higher expenses, and premiums will be higher," Leckman said.

Leckman said IHC is developing insurance plans that allow consumers to choose physicians who aren't on its panels. Employers will be able to buy the plans in January.

IHC also came under fire for recruiting physicians into communities where their specialties are not needed, putting pressure on independent doctors whose practices need patient revenues to pay expenses.

"Individuals outside the [IHC] system may not have the resources and business to compete and bring quality and cost-effectiveness to consumers," said Tom Dickenson, a Utah County gastroenterologist.

Dickenson said IHC often makes decisions without considering their effects on non-IHC-affiliated doctors, while communication between both sides has broken down.

After the meeting, Sen. Mike Waddoups, R-Taylorsville, said the level of bitterness evident during the meeting didn't surprise him.

"I heard a lot of complaints that I'd heard before we started. We heard about physician access. We heard about physician choice," said Waddoups, who co-chairs the task force.

"But we also heard that things are changing, that IHC is being more cooperative. It's proof that the task force and government are accomplishing something good, even though we haven't passed any bills. The fact that IHC is recognizing some of the problems, I consider that a victory."

TAKING ON IHC

--Who: The Privately Owned Health Care Organization Task Force

--What: A 15-member legislative group formed to examine the business practices of Intermountain Health Care, a tax-exempt, Salt Lake City-based health care corporation.

--Why: IHC provides 55 percent of inpatient hospital service in Utah. It employs 460 out of about 4,000 physicians in the state. It has an insurance division that controls more than 40 percent of the Utah health insurance market. With few exceptions, IHC's insurance plans contract exclusively with IHC-owned hospitals and clinics.

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Source: The Salt Lake Tribune

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