The move signals a change in how the region’s dominant insurer manages skilled nursing and home health options for its members, Highmark’s vice president of market strategy Robert Wanovich told the Pittsburgh Post-Gazette.
In the past, Highmark “really didn’t focus on post-acute care,” said Mr. Wanovich. “We learned that it was very important for hospitals and doctors to have insight into the quality of care and readmission rates that are coming from these types of services” so they can identify the facilities that Highmark believes offer access to the best quality of services for the best price.
Connie Slampak, administrator for Abby Home Health Services in Uniontown, Pa., commented on Abby’s recent contract termination with Highmark. After Highmark notified Abby last fall that reimbursement payments would be reduced by 21 percent, the insurer issued a notice of contract termination in December.
“This was totally unforeseen,” Ms. Slampak told Pittsburgh Post-Gazette. “To have my contract cut for no reason is kind of demeaning.”
Excluded facilities and agencies extend from Erie to FayetteCounty and include businesses that have been a part of Highmark’s network for decades.
“Disruption is certainly not something we take lightly,” Mr. Wanovich told Pittsburgh Post-Gazette, “but at the same time our members expect us to provide them with quality, affordable services, so that is the balance we’re always attempting to strike.”
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