Page 11 - SOUTH FLORIDA HOPSITAL NEWS APRIL 2022

Changing the Perception Behind

Provider vs. Payor Tug-of-War

It’s no secret that posi- of ensuring access to excep-
tive relationships with tional care and improving
health insurance compa- the health of the communi-
nies are essential to the ties we humbly serve. Holy
well-being of health sys- Cross Health knows this tug-
tems. At Holy Cross of-war all too well as a not-
Health, our ability to pro- for-profit health system, but
vide high-quality and without support from pay-
affordable care to those ors, both Holy Cross and our
who need it most across community suffer. We invest
Broward County relies on wholeheartedly back into the
the collaboration and community for every dollar
cooperation of our indus- BY RONALD we earn by obtaining new
try partners – the insur- BRANDENBURG technologies to improve
ance companies, or pay- healthcare services, upgrad-
ors, who reimburse us for the patient ing facilities and ensuring our doors
care we deliver. remain open to everyone – regardless of
However, an inevitable game of tug-of- their ability to pay. We pride ourselves on
war is played when market pressures on these values because we know they are
providers become unsustainable. As a the foundation of all we do. Still, resist-
alists
result, both parties commonly enter ance exists. Pediatric Specia
negotiations to modify contracts and The list of daily and ongoing chal-
business agreements that may no longer lenges health systems across the country
me
be viable. Time and time again, providers face is tiring and includes inflation, Close to Hom
are offered negligible increases or even staffing shortages, continued treatment
met with unsustainable reductions in for COVID-19 patients and investments
compensation that jeopardize our ability in the safety of our staff members who Whether you’re in Naples, Miami or W est Palm

m Beach —

We
to provide the high-quality, essential provide this care daily. Firm resistance at or somewhere in between — KIDZ Medical physicians

hi i

services that patients deserve and expect. the negotiating table from our industry
y.. W
e are a physician-owned pedia atric multi-
And while we try everything to avoid peers only increases the economic strain are nearby We
it, far too often, patients suffer immense- so many of us are facing today, inevitably specialty practice offering state-of-the-art ca are throughout
ly when negotiations go awry and cause putting patients and employers at risk of

undesired disruption. Across our nation, disruption in their care. South Florida.
participation in employer-sponsored We are humbled that we have been
health plans remains significant, with able to serve our community with high-
approximately 157 million covered lives quality care for over 60 years, and we
according to Kaiser Family Foundation work every day to strengthen our rela-
in 2020. This health insurance benefit tionship with payors who help us keep
employers provide can swiftly depreciate our doors open. I hope that negotiations
as the cost of premiums rise while the will no longer be viewed as a tug-of-war
volume of quality care providers consid- between two “goliaths” because this per-
ered "in-network" shrinks. What’s more, spective removes what matters – the
any purposeful initiative between the patient. At Holy Cross Health, we firmly
health system and employer to identify believe that everyone deserves access to
areas for cost savings, employee utiliza- the healthcare they know and trust to
tion, or benefits education is wasted deliver compassionate care services. We
when the provider and payor cannot remain committed to working toward a
reach a mutually agreeable arrangement. better tomorrow, as should every health
The patient no longer has affordable system, including a collaborative rela-
access to trusted primary care providers tionship between the parties who pro-
or specialists. The provider loses revenue vide and reimburse healthcare.
that jeopardizes business operations. The
health plan fails providers but maintains Ronald Brandenburg is
premiums. Vice President and Chief Financial
Collaboration is essential for the sake Officer, Holy Cross Health.
K K K K K I I I I I Z Z Z Z Z
M l
Medical
Providing care to infants, c d l i h e re r n
and moms since 1988
Boca Raton • W est Palm Beach • Port St. Lucie • Hollywood
We
Miramar • Doral • Miami • South Miami • Kendall • Homestead
Naples • Bonita Springs

South Florida Hospital News southfloridahospitalnews.com April 2022 11