On February 2, 2024, HCSC, an independent licensee of the Blue Cross Blue Shield Association, announced its intention to complete its acquisition of Cigna’s Medicare businesses for $3.3 billion.  Let that sink in.  How many of you are fighting for increased reimbursements? How many of you are accepting contracts from private payers at rates BELOW Medicare? 

Do you think Blue Cross would pay $3.3 billion dollars if they didn’t think they would get a good return on that investment? How do you think they will realize that profit?  They are going to maximize the margin between what CMS pays and what they pay you!  Forget O&P…why do we as Americans allow our government to squander this kind of money? Every Medicare beneficiary is disadvantaged by this and every health care provider is harmed by this. They are basically reselling health insurance that we taxpayers fund. How does that make sense? Far be it from me to ever say our government is efficient at anything, but to think Medicare beneficiaries and health care providers are better off with a middleman skimming money from every transaction is ludicrous, at best. 

The press release goes on to say “If the acquisition is successful, HCSC will significantly expand its Medicare membership. The payer already has 1 million Medicare beneficiaries. Cigna’s businesses will bring in 3.6 million Medicare beneficiaries, 600,000 Medicare Advantage plan members, over 450,000 Medicare Supplemental plan members, and 2.5 million members in Medicare Part D.” 

The only way to stop the insanity is by getting involved.  By the law of averages, most of us are moderates.  We are center right or center left in our views.  We are the quiet majority.  The vocal minority are the activists, the screamers, and attention getters. 

It is time for the sane crowd to fight for what is right.  As a member of the community of O&P, I implore each of you to reach out to the national organizations that purport to represent us and encourage them to align in the fight for proper payment for services.  There is pressure all around, but why on Earth does this profession accept reimbursement rates below Medicare?   

Step up, oh hoard of moderate, sane people, and fight for more sanity!  Reach out to your elected officials, and better yet, have your patients reach out their elected officials too.  Quit thinking of your peers as competitors and realize that the only way for us to prevail is together.  The future of professional O&P patient care is riding on it!  It is time for the masses to take to the streets!  Don’t undervalue your services and make sure you fight for your value!