May 06, 2004

Health Alliance and the CMS bidding process: What the heck is it? 

So Health Alliance rated No. 1 on quality of service, says Paul Solitto, deputy director of benefits for the Illinois Department of Central Management Services, which awards contracts to health insurance providers for state employees after a bidding process. He says factors other than quality went into the agency's decision to terminate its contract with Health Alliance. But the News-Gazette reports quality was 75 percent of the total score, with cost supposedly accounting for 25 percent. How do we compare costs among bidders? Turns out it's a formula based on "per employee per month estimated costs provided by each bidder," each of whom uses different assumptions in making their case for a state contract. Sounds like throwing darts, apples vs oranges, or pick your own metaphor. One might feel sorry for any state administrator who has to explain denying a contract renewal to the provider with the highest quality of service. But let's save some empathy for thousands of families who would no longer have access to their family doctors, nurse practitioners, and other health care specialists with whom they've developed strong relationships. It's only quality of service. The state has to save some dollars, or at least look like it is.

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