While 50,000 Mississippians face the prospect of going without affordable medical care thanks to a contract dispute between the state’s largest hospital and insurer over reimbursement rates, the salaries for executives at both entities are shielded from the public.
Blue Cross & Blue Shield of Mississippi sued the state over a decade ago to make sure its executives’ compensation could not be disclosed, and the University of Mississippi Medical Center — despite being under the purview of the Institutions of Higher Learning and receiving state and federal funding — cites a broad exemption in state law when withholding its top administrators’ salary information.
Blue Cross & Blue Shield of Mississippi is required to file information about its executives’ compensation as part of its annual report to the Mississippi Insurance Department. But in 2009, the insurer sued the department to stop it from releasing that information to the public.
Several current executives at the company — Carol Pigott, the CEO; Thomas Fenter, the chief medical officer; and Bryan Lagg, senior vice president of consumer marketing and sales — are listed as plaintiffs in court filings.
Hinds County Chancery Court Judge Patricia D. Wise sided with Blue Cross, ordering the department “to withhold from public disclosure all information concerning the compensation of BCBSM executives.” Wise determined that the Insurance Department didn’t use the information to carry out its duties, so it isn’t a public record, and that disclosing the salary information would violate “the privacy rights of the individual plaintiffs/executives.”
Top executives make seven figures, a longtime former employee of the insurance company told Mississippi Today.
The median household income in Mississippi is around $46,000.
“Salaries and employee compensation of all employees at BCBSMS is not pertinent to the contract dispute with UMMC, and simply distracts from what is really important — high-quality, cost-effective care for our Members,” Cayla Mangrum, manager of corporate communications for the company, said in a statement to Mississippi Today.
But Mississippians faced with exorbitant health care costs or the added burden — financial and otherwise — of driving elsewhere for care might see it differently.
Carmen Balber, executive director of the nonprofit consumer advocacy group Consumer Watchdog, said that health insurance is essentially a public good, even when delivered through private companies.
“At the end of the day, we’re paying for those salaries,” she said, speaking about health insurance companies generally because she doesn’t have specific knowledge of BCBS Mississippi. “I’m certain that any consumer who’s had issues with their health insurance, paying for what they need, would be very interested to know that the CEO of the company was making $1 or $2 or $6 million a year.”
In many other states, that information is public record. In California, for example, an executive compensation report published annually on the company’s website shows their top executive made $6.4 million in 2020. In Michigan, the company’s CEO made $15.6 million in 2021. A spokesperson for the Blue Cross Blue Shield Association, the umbrella group for 34 different BCBS companies, said they did not have information about the number of states in which BCBS executive compensation is withheld from the public.
A 2016 survey by the National Association of Insurance Commissioners of its members around the country found that insurance company compensation figures were kept confidential in at least 12 states, including Mississippi.
The company awards yearly bonuses to employees — as much as six figures for executives — around March each year, said the former BCBS employee, and the amounts of the bonuses also increased in recent years.
The company told Mississippi Today the bonuses are “an important part” of incentive-based compensation.
“Blue Cross & Blue Shield of Mississippi (BCBSMS) is proud of our employee incentive program because it rewards (and thanks) our employees for their individual performance and contribution to the achievement of the Company’s health and wellness goals for our Members,” Mangrum said.
Though the University of Mississippi Medical Center receives about 9% of its funding from the state, the hospital shields its executives’ compensation, too. When Mississippi Today requested hospital salary information last year, UMMC invoked the broad hospital exemption in the state’s public records law to withhold the information. When reporters asked the Institutes of Higher Learning for the salary information this week, a spokesperson cited the law and said UMMC employees’ salaries are exempt from disclosure.
The salary for Dr. LouAnn Woodward, vice chancellor of health affairs and dean of the school of medicine, was $700,400 a year in 2016, according to a news article.
A 2021 report by the Economic Research Institute showed the average nonprofit hospital CEO made $600,000 in 2018.
On March 31, Blue Cross and UMMC missed their deadline to sign a new contract, forcing tens of thousands of patients to pay higher costs for out-of-network care at the hospital, or go elsewhere. UMMC maintains it has been underpaid relative to other academic medical centers in the region and is asking for a 30% overall increase in reimbursement rates from Blue Cross in the first year of a new contract. Blue Cross argues that’s too much.
Contract disputes between the two have been tense in the past, but this is the first time UMMC has gone out of network with Blue Cross, hospital officials said.
In 2009, reporters from WLBT requested information on Blue Cross Blue Shield executive compensation from the Insurance Department, on behalf of several policyholders who wanted to know where their money was going.
Blue Cross then sued the Insurance Department, triggering the court order in their favor.
Last week, Mississippi Today filed a records request with the Mississippi Insurance Department for the executive compensation information Blue Cross Blue Shield is required to file with the state annually. The department responded that the 2009 court order prohibits it from fulfilling the request.
“In accordance with the Court’s directive, MID is prohibited from releasing the aforementioned information which is the subject of your request,” wrote deputy commissioner Mark Haire.
Historically, public hospital records were exempt from public disclosure. But after Singing River Health System in Pascagoula secretly stopped paying into its pension system from 2009 to 2014 as it faced a hidden financial crisis, legislators moved to require greater transparency. Public hospitals are now required to share board meeting minutes and financial records. But employee salaries and personnel records are still exempt.
In a statement to Mississippi Today, Blue Cross said they make money not from customer premiums but from “administrative efficiency and investments.” They also said they outperform federal requirements for the percentage of customer premiums they spend on claims, a figure called the medical loss ratio. For large employer groups, the requirement is 85%; Blue Cross says it hit 94%. For individuals, the requirement is 80%, and Blue Cross reached 99%.
“Our medical loss ratio performance clearly illustrates Blue Cross & Blue Shield of Mississippi’s ability to ensure the vast majority of the Member’s premium is for health care costs,” the statement said.
In other states, legislatures have passed laws preventing disclosure of insurers’ executive compensation. Alabama, for example, used to release the information publicly. In 2015, following lobbying from the insurance industry, the law changed to make salaries confidential.
Alabama health care attorney Jim McFerrin told AL.com that making salary information public gave customers more information about where their money was going and could allow them to take legal action in certain situations – like, for example if they believed a rate increase was unreasonable.
“A decrease in transparency means a decrease in accountability,” he told the news site.
Mississippi Today reporter Molly Minta contributed to this report.
Editor’s note: Kate Royals, Mississippi Today’s community health editor since January 2022, worked as a writer/editor for UMMC’s Office of Communications from November 2018 through August 2020, writing press releases and features about the medical center’s schools of dentistry and nursing. A longtime journalist in major Mississippi newsrooms, Royals had served as a Mississippi Today reporter for two years before her stint at UMMC. At UMMC, Royals was in no way involved in management decisions or anything related to the medical center’s relationship or contract with Blue Cross and Blue Shield of Mississippi.