Here are five things to know.
1. Tower Health, formerly Reading Health System, rejected Independence’s in-network deal prior to completing its purchase of the hospitals Oct. 1. The five affected Pennsylvania hospitals include Brandywine Hospital in Coatesville, Phoenixville Hospital, Pottstown Memorial Medical Center, Jennersville Regional Hospital in West Grove and Chestnut Hill Hospital in Philadelphia.
2. Philadelphia-based Independence had provider agreements with the five former CHS hospitals slated to expire next year. Anthony Coletta, MD, president of Independence, said the payer “provided the new parent company, Reading Health System [now Tower Health], with a fair and reasonable proposal to assume these contracts based on our careful consideration of various factors, including the potential long-term impacts to Independence customers. Unfortunately, on Friday, Sept. 29, Reading informed us that they did not accept our proposal.”
3. Pittsburgh-based UPMC operates a joint health plan with Tower Health, according to The Philadelphia Inquirer. The joint venture means Tower Health’s plan would compete directly with Independence’s plan.
4. Dr. Coletta told the publication when negotiations began between Independence and Tower Health two weeks ago, “they made it clear they intended to actively compete with us and other health plans.”
5. Independence will cover approximately 120,000 affected members for at least the next 30 days. Tower Health did not immediately respond to The Philadelphia Inquirer‘s request for comment.
More articles on payer issues:
Humana to offer older employees early retirement
Critics argue Anthem’s new outpatient imaging policy is at odds with promoting quality
Survey: Most patients’ insurance premium price ceiling is $100 per month
