Bayhealth Medical Center, Highmark BCBS of Delaware in contract dispute

Dover, Del.-based Bayhealth Medical Center will soon be an out-of-network provider for Highmark Blue Cross Blue Shield of Delaware members unless the two sides resolve rate disputes, according to The News Journal.

The current contract between Bayhealth and Highmark expires May 15. Both sides said they want a resolution but are preparing for a contract lapse, according to The News Journal.

At the center of the contract disagreement is the reimbursement rates paid to Bayhealth by Highmark for various treatments.

Tim Constantine, president of Highmark Blue Cross Blue Shield of Delaware, told The News Journal, "We have been successful in negotiating these types of arrangements with every other adult acute care hospital in Delaware. We have not yet been successful in converting the Bayhealth contract into a value-based contract."

Terry Murphy, CEO of Bayhealth, told The News Journal hospital management has agreed to the greater financial risk associated with the new model. However, the hospital notes, the rates involved have stalled negotiations.

 

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