19 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. Anthem Blue Cross and Blue Shield of Missouri confirmed the provider network for the insurer's health plans sold through the state's new online marketplace won't include St. Louis-based BJC HealthCare, which operates 13 hospitals in the state.

2. Inova Health System — a five-hospital system based in Falls Church, Va., and one of the largest networks around the Washington, D.C., area — and health insurer Kaiser Permanente said they will not renew their contract after roughly seven months of negotiations.

3. University of Pittsburgh Medical Center and insurance company Highmark continued running negative attack advertisements against each other, and a task force formed by Pennsylvania Gov. Tom Corbett seems to have withdrawn a request that the companies stop running the ads.

4. Mississippi lawmakers said at a legislative hearing that they might intervene in the dispute between Blue Cross & Blue Shield of Mississippi and 10 state hospitals owned by Naples, Fla.-based Health Management Associates if the health insurer and hospital operator can't resolve the conflict on their own.

5. Executives at Bon Secours Hospital in Baltimore told the Maryland Health Services Cost Review Commission they want to join the state's pilot program for lump sum payments.

6. Quality Health Solutions, a collaborative of health systems in Wisconsin and the Medical College of Wisconsin in Milwaukee, announced an accountable care initiative with UnitedHealthcare.

7. VHS Phoenix Health Plan, the Arizona-based health insurer within Nashville, Tenn.-based Vanguard Health Systems, signed a new three-year contract with Arizona's Medicaid program.

8. New Hanover Regional Medical Center and multispecialty medical group practice Wilmington Health, both based in Wilmington, N.C., announced they are launching an accountable care alliance with Blue Cross Blue Shield of North Carolina.

9. For-profit hospital operator CarePoint Health officially sought to become a licensed Medicaid provider for residents of Hudson County in New Jersey.

10. Lebanon, N.H.-based Dartmouth-Hitchcock, Manchester, N.H.-based Elliot Health System and Harvard Pilgrim Health Care of New England created a new nonprofit, defined-network health plan for employers and employees in New Hampshire.

11. Blue Cross Blue Shield of Texas created a partnership with Memorial Hermann Accountable Care Organization, the ACO of Houston-based Memorial Hermann Health System.

12. The Florida hospitals affiliated with Nashville, Tenn.-based Hospital Corp. of America agreed to a new two-year contract with health insurer Humana.

13. Kingsport, Tenn.-based Wellmont Health System has rejected an "unacceptable" contract from UnitedHealthcare.

14. A study from the Center for Studying Health System Change found the highest-priced hospitals within a market often have charges that are 60 percent higher than the lowest-priced market competitor, and the high-priced hospitals often wield an immense amount of influence in their areas.

15. Jersey City (N.J.) Medical Center and Horizon Blue Cross Blue Shield of New Jersey signed a letter of intent to launch a value-based, patient-centered program later this year.

16. Tacoma, Wash.-based MultiCare Health System and Regence BlueShield in Washington announced a new accountable care initiative.

17. MemorialCare Health System, a six-hospital network based in Fountain Valley, Calif., launched its new insurance arm, Seaside Health Plan.

18. Hundreds of state residents at a public hearing criticized the proposed transfer of thousands of people to a new insurance plan under an in-progress partnership between Anthem Blue Cross and Blue Shield and Portland-based MaineHealth.

19. York (Maine) Hospital and Maine Community Health Options established a collaborative partnership.

More Articles on Hospitals and Payers:
Safety-Nets: Can They Go From "Last Resort" to "Hospitals of Choice?"
Being Strong is Adapting: Q&A With Tahlequah City Hospital CFO Julie Ward
At the Forefront: How Hospitals and Health Systems Can Be on the Cutting Edge With Payers

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