14 Recent Issues Between Hospitals and Payors

Here are 14 recent issues that occurred between hospitals, health systems and payors within the past month, starting with the most recent.
1. Highmark Seeks Injunction Against UPMC to Stop Sharing Confidential Documents
Pittsburgh-based health insurer Highmark sought an injunction to stop University of Pittsburgh Medical Center from sharing confidential Highmark documents the health system mistakenly received.

2. Bill to Ensure Coverage of Telemedicine Services Introduced in Montana Senate Committee
Montana State Sen. Ed Buttery (R-Great Falls) sponsored a bill that would require health insurers to cover services provided via telemedicine.

3. 8 Statistics on Illinois' Healthcare Market
A report found that in 2011, Illinois-based HMOs had $370.9 million in net income, 7.3 percent of their combined $5.06 billion in revenue.

4. Highmark's Affiliations With West Penn, Jefferson Regional Receive County Approval
Pittsburgh-based health insurer Highmark got one step closer to creating its regional health system, as the Orphan's Court of Allegheny County approved Highmark's affiliations with West Penn Allegheny Health System in Pittsburgh and Jefferson Regional Medical Center in Jefferson Hills, Pa.

5. South Dakota Bill Would Allow Providers to Treat Patients Enrolled in Any Health Plan
South Dakota legislators proposed a bill that would allow physicians to treat patients enrolled in any insurance plan in the state, as long as the providers are willing to meet the plans' terms and conditions.

6. Trinity Health CEO Joseph Swedish Resigns for WellPoint CEO Post
Livonia, Mich.-based Trinity Health announced Joseph Swedish, Trinity's president and CEO, will resign next month to become CEO of health insurer WellPoint in Indianapolis.

7. Michigan Enforcing Ban on Most-Favored-Nation Contracts
Michigan's ban on most-favored-nation contracts between health insurers and hospitals went into effect.

8. Carondelet Health Network in Arizona Pursues Population Health Plan
Carondelet Health Network, a Tucson, Ariz.-based affiliate of Ascension Health, announced it has signed an exclusive agreement with Healthways to build a population health management plan for its market.

9. Loyola University Health System in Illinois Joins Aetna's Network
Health insurance giant Aetna announced it has added Loyola University Health System, based in Maywood, Ill., to its network, effective March 1.

10. University of Colorado Health May Add Health Insurance Arm
Roughly one year after University of Colorado Health was created through the merger of University of Colorado Hospital in Aurora and Poudre Valley Health System in Fort Collins, Colo., UCHealth contemplated whether it will launch a health plan.

11. Report: Out-of-Network Provider Charges Strain Healthcare System
Out-of-network physicians and providers have been found to charge patients up to 100 times higher than what Medicare would pay, and a report from America's Health Insurance Plans — the lobbying arm of the health insurance industry — said this is exacerbating the healthcare cost crisis in the country.

12. WellPoint Offers Telemedicine Program to Physicians
Indianapolis-based health insurer WellPoint began offering some physicians the chance to be paid for consultations through online video, without having to submit claims.

13. Highmark to Give Jefferson Regional $21M Upon Finalization of Affiliation
Pittsburgh-based health insurer Highmark said it would give Jefferson Regional Medical Center an "unrestricted" $21 million upon finalization of its affiliation agreement.

14. S&P: West Penn Deal Weakens Highmark's Financial Profile
Standard & Poor's Ratings Services released a report affirming the "A" long-term credit rating on Highmark but cut the Pittsburgh-based health insurer's outlook to negative from stable due to concern of future operating performance.  

More Articles on Hospital-Payor Relationships:

5 Long Hauls for Hospitals and Health Systems
Legacy Salmon Creek in Washington Partners with Kaiser
BayCare Health Back in UnitedHealthcare Network

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