Hartford (Conn.) Hospital has lost a battle to crosstown rival Saint Francis Hospital and Medical Center for business from patients insured by Cigna HealthCare of Connecticut as the insurer moves to control costs.
Cigna HealthCare announced last week that it will end its affiliation with Hartford Hospital on Sept. 8 and create a new network of physicians affiliated with Saint Francis and its sister hospital in Hartford, Mount Sinai Hospital.
The decision is a coup for Saint Francis, which won by submitting a bid that was about one-third lower in price than Hartford Hospital's. It also is evidence of the increasingly competitive nature of the healthcare marketplace in the era of managed care.
For the 8,500 people who have Cigna insurance and whose physicians are affiliated with Hartford Hospital, it will mean a change either in their doctor or their hospital. They will lose the choice they now have between having a physician affiliated with either hospital.
"We regret deeply this action is going to cause anxiety among patients and result in some patients' changing doctors," said R. Channing Wheeler, president of Cigna HealthCare. "If there was a way we could make this change occur in a different manner we would have done it. Administratively, it was impossible."
Mr. Wheeler said part of the reason for the change is to get better control of the network. He said nearly every doctor with admitting privileges to Hartford Hospital now is a member of the network, and Cigna wants to limit the network to physicians with the best record of providing quality care while limiting costs.
Cigna's action is "another example of insurance companies acting in their own financial self-interest at the expense of the patients' freedom to select their own physicians," ProCare IPA, the association of physicians that formed the existing network, said in a written statement. Termination of the contract will cause "substantial disruption" for patients, the statement said.
An estimated 80% to 90% of the Hartford Hospital physicians now in the Cig-na network are expected to be granted admitting privileges at Saint Francis and to be allowed into the new, somewhat different Cigna system.
Even if a person is able to stay with the same physician, that doctor will have to provide treatment in the future at Saint Francis.
Some services, however, are not available at Saint Francis or Mount Sinai. Because Saint Francis is a Roman Catholic hospital, it doesn't provide abortion, birth control or other reproductive health services.
A Saint Francis executive said most such services now are provided in outpatient clinics and that patients could be referred to other hospitals in the Cigna system if they need inpatient services.
Others among the 85,000 Cigna subscribers in Hartford and Tolland counties may be affected by a change in the nature of the network. Because of the change, not all physicians who now are in the network will want to stay.
Neither hospital nor Cigna executives would release information on the amount of the bids, but a Cigna official said the Saint Francis bid was 30% to 35% lower than Hartford Hospital's.
The decision to drop Hartford Hospital and go with Saint Francis will allow Cigna to save $1 million in administrative costs by the end of 1995, Mr. Wheeler said.
Cigna's medical care costs were higher in Connecticut than anywhere else in the United States, Mr. Wheeler said.
The company insures more than 3.1 million nationwide. About 125,000 Connecticut residents are covered through Cigna HealthCare of Connecticut. The company had a net profit of $3.4 million in 1993 on revenues of $140.4 million.