17 Recent Issues Between Hospitals and Payers

The following are the latest issues that occurred between hospitals, health systems and payers within the past month, starting with the most recent.

1. Carroll County Memorial Hospital in Carrollton, Ky., joined insurer Aetna's Kentucky network.

2. Yale-New Haven Hospital in New Haven, Conn., joined the Consumer Health Network preferred provider organization, a division of Lansdale, Pa.-based Consolidated Services Group.

3. St. Clair Hospital and health insurer Highmark, both based in Pittsburgh, signed a new multiyear reimbursement contract.

4. Two California hospitals within Dallas-based Tenet Healthcare Corp. have until July 31 to reach a new contract with health insurer UnitedHealthcare.

5. Blue Cross & Blue Shield of Mississippi, the largest health insurer in the state, sent a termination notice to Naples, Fla.-based Health Management Associates indicating it will ax contracts with Health Management's 10 hospitals by the end of August.

6. Blue Cross Blue Shield of Illinois and five other health insurers said they will offer plans on Illinois' health insurance exchange this fall.

7. Major health insurers including UnitedHealthcare, Cigna and Assurant Health indicated they will not offer insurance policies this October in Missouri's federally run health insurance exchange.

8. UnitedHealthcare opted not to participate in the new health insurance exchange in Arizona.

9. Fourteen different health insurers, some of which are run by health systems, applied to sell health plans on Michigan's health insurance exchange.

10. Roseville, Calif.-based Adventist Health, a 19-hospital system, said it plans to get a limited HMO license.

11. A study showed the number of providers with risk-based contracts for total cost of care more than doubled since 2011.

12. A survey found the majority of hospital and health systems have begun talks with payers about participation in health insurance exchanges, and a fourth of them have negotiated with at least five payers.

13. UnitedHealthcare said it plans to more than double its accountable care health plan contracts with hospitals and physicians by 2017.

14. In an attempt to quell an extended dispute with University of Pittsburgh Medical Center, the president and CEO of Highmark penned an op-ed in the Pittsburgh Post-Gazette saying his company "wants a multiyear contract" with the healthcare giant.

15. More than eight different hospitals, physician groups and health networks created accountable care initiatives with private payers in the past month.

16. Three hospitals and health systems in Tennessee struck agreements with Community Health Alliance, the state's lone Consumer Operated and Oriented Plan.

17. University of Iowa Health Alliance, a coalition of four Iowa health systems, partnered with one of the largest CO-OPs, CoOportunity Health, to create two health plans for state residents.

More Articles on Hospitals and Payers:
50 Things to Know About the Hospital Industry
9 Fewer Pioneer ACOs: Healthcare Experts on What This Means for Accountable Care
5 Key Trends in Healthcare for 2013

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