11 updates on payer, provider relationships

Here are 11 recent articles posted by Becker's Hospital Review that concern payer-provider relationships:

1. North Carolina treasurer: State health plan members will have in-network coverage at major hospitals
North Carolina Treasurer Dale Folwell has revealed a new combined network that will ensure members of the state's health plan have in-network coverage at major hospital systems for 2020.

2. WellStar says Anthem Blue made false representations to customers           
After months of mediation, a lawsuit filed by WellStar Health Systems against Blue Cross Blue Shield Healthcare Plan of Georgia, known as Anthem Blue, is still pending.

3. Renown Health, Anthem agree on network deal            
Reno, Nev.-based Renown Health and Anthem have reached an in-network agreement.

4. BCBS of Michigan hit with $40M lawsuit over provider payments           
Blue Cross Blue Shield of Michigan faces a lawsuit filed on behalf of mental health and substance abuse treatment providers that accused the insurer of underpaying claims.

5.SSM Health launches health plan in St. Louis           
St. Louis-based SSM Health is rolling out a health plan in the St. Louis region this fall, marking the health system's first individual health insurance option in the area.

6. UAB, UnitedHealth reach tentative agreement            
The University of Alabama at Birmingham Health System and UnitedHealthcare reached a tentative agreement on their contract July 31.

7. Minnesota hospitals say BCBS' incompetence, not prior authorization, is the problem        
Minnesota hospitals are questioning Blue Cross Blue Shield of Minnesota's competence as the insurer imposes new limits on care.

8. BCBS of Mass. CEO: Global payment success 'shows we don't have to wait for political consensus to act in healthcare'            
A recent study published in The New England Journal of Medicine found Blue Cross Blue Shield of Massachusetts' global budget payments slowed down spending growth while improving healthcare quality — achieving what BCBS of Massachusetts' CEO referred to as the "holy grail in healthcare": higher quality at a lower cost.        

9. Zuckerberg San Francisco General inks first contract with commercial payer            
San Francisco's health network — which includes Zuckerberg San Francisco General — finalized its first contract with a private health plan.

10. Memorial Sloan Kettering, Cigna strike value-based agreement            
New York City-based Memorial Sloan Kettering and Cigna signed a value-based agreement under which Memorial Sloan will share savings with Cigna if cost and quality targets are hit.

11. Integris, BCBS reach unprecedented 5-year agreement    
Blue Cross and Blue Shield of Oklahoma and Oklahoma City-based Integris Health inked a five-year agreement centered on value-based payments.

More articles on payers:
WellStar says Anthem Blue made false representations to customers
Kansas threatens termination of Aetna's Medicaid contract
1 system joins North Carolina's controversial reimbursement plan in 2nd sign-up period

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


Top 40 Articles from the Past 6 Months