Quality care costs; CareFirst should raise rates

It didn’t surprise me to read that Johns Hopkins may remove its doctors from CareFirst BlueCross BlueShield’s insurance network. I had just received a statement of benefits from CareFirst for a recent cardiac procedure done at the main hospital. This statement clearly demonstrated why Hopkins might consider such a step.

The hours-long catheter ablation I had to resolve intractable tachycardia was a complicated procedure performed by an electrophysiologist assisted by a highly skilled team. It involved running laser-tipped wires through my veins to the heart using X-ray technology and then burning away the problem areas.

The electrophysiologist’s bill for professional medical services was $700. CareFirst reimbursed $113. For the X-ray portion of the bill, the charge was $200. CareFirst reimbursed $16. Overall, the bill was reduced by more than two-thirds.

Such payments are insulting to the doctors and dangerous for the thousands of patients who stand to lose access to them. Hopkins doctors provide some of the most highly specialized care in the area, and in some cases may be the only option. Carefirst’s lukewarm suggestion that it could help members find other providers ignores both this fact and the sheer number of patients involved.

CareFirst needs to do the right thing and raise its rates, both out of respect for the physicians and concern for their patients. It is not a poor organization. The Sun noted in 2017 that the CEO’s salary was difficult to calculate but that in 2003 it was more than $3 million, with incentives. Given this fact, one might ask whether CareFirst believes its executives are worth far more than the doctors who might one day save their lives.

— Emily Chalmers, Baltimore