Blue Cross, Tower Health reach 3-year agree­ment

The Southern Berks News - - FRONT PAGE - By Donna Rovins drovins@21st-cen­tu­ry­ @Mer­cBiz on Twit­ter

In­de­pen­dence Blue Cross and Tower Health have reached an agree­ment on a new, three-year con­tract, ef­fec­tive im­me­di­ately, end­ing a nearly week-long con­tract dis­pute that jeop­ar­dized hos­pi­tal ac­cess for 120,000 peo­ple.

Fri­day’s an­nounce­ment en­sures that In­de­pen­dence Blue Cross mem­bers will con­tinue to re­ceive “in-net­work” health care cov­er­age at Pottstown, Phoenixville, Brandywine, Chest­nut Hill and Jen­nersville hos­pi­tals and their af­fil­i­ated physi­cians.

“We wanted to get this re­solved so our pa­tients and mem­bers have con­fi­dence and trust in their lo­cal providers and didn’t feel threat­ened by this ne­go­ti­a­tion going on be­tween In­de­pen­dence Blue Cross and Tower

Health. It is good for both of us to get to this point,” Clint Matthews, Tower Health pres­i­dent and CEO, said in an in­ter­view Fri­day.

The two companies is­sued a joint state­ment Fri­day from Matthews and An­thony V. Co­letta, pres­i­dent of In­de­pen­dence Blue Cross Fa­cil­i­tated Health Net­works.

“Pro­vid­ing pa­tients, mem­bers, and com­mu­ni­ties con­tin­ued ac­cess to qual­ity, af­ford­able care in this re­gion is para­mount for both or­ga­ni­za­tions; and re­solv­ing these dis­cus­sions quickly was in the best in­ter­est of mem­bers and pa­tients,” the state­ment read in part.

“We are con­fi­dent that this agree­ment will serve as the foun­da­tion for a strong re­la­tion­ship be­tween our two or­ga­ni­za­tions,” the state­ment con­tin­ued.

It is welcome news to the 120,000 Blue Cross mem­bers who were told ear­lier this week that the hos­pi­tals and their providers were no longer con­sid­ered to be “in-net­work” with In­de­pen­dence Blue Cross, fol­low­ing the fi­nal­iza­tion of Tower Health’s ac­qui­si­tion of the five hos­pi­tals. Read­ing Hos­pi­tal in West Read­ing will also re­main in the In­de­pen­dence Blue Cross net­work un­der the terms of the agree­ment.

“I view this as a win­win-win,” Matthews said Fri­day. “It’s a win for pa­tients, for mem­bers and the Tower Health hos­pi­tals — to be able to pro­vide the care that our pa­tients have trusted in for a long time.”

Matthews pointed out that pa­tients should not no­tice any change, “there will be no break in ser­vice — no change in mem­ber ser­vices.”

Terms of the agree­ment were not dis­closed.

“We wanted to work dili­gently to get the is­sue re­solved. There was rig­or­ous ne­go­ti­a­tion. We re­moved the stick­ing points we wanted to re­move. We’re pleased we have an agree­ment that is long-term,” Matthews added.

On Sept. 29, Tower Health fi­nal­ized its pur­chase of the five area hos­pi­tals that had pre­vi­ously been owned by Franklin, Tenn.-based Com­mu­nity Health Sys­tems Inc. The new com­pany be­came ef­fec­tive Sun­day, Oct. 1. Tower Health, which also owns Read­ing Hos­pi­tal, had pre­vi­ously been known as Read­ing Health Sys­tem.

On Oct. 1, In­de­pen­dence Blue Cross put its mem­bers on no­tice that its provider agree­ments with the hos­pi­tals were end­ing be­cause the two companies had failed to reach an agree­ment by the time the sale closed Sept. 29. The in­surer in­di­cated at that time that its mem­bers would con­tinue to be cov­ered for 30 days.

It also be­gan a com­mu­ni­ca­tion cam­paign with mem­bers that in­cluded let­ters, dig­i­tal me­dia and text mes­sag­ing. Both companies said on Mon­day they were open to con­tin­u­ing to dis­cuss an agree­ment.

Co­letta told Dig­i­tal First Me­dia on Mon­day that the con­tract In­de­pen­dence had with Com­mu­nity Health Sys­tems Inc. be­came null once the sale was com­pleted. He in­di­cated the in­surer had pre­sented a pro­posal to Tower Health that would have al­lowed the agree­ment to con­tinue — a pro­posal he said was re­jected by Tower Health.

Tower Health had a dif­fer­ent take on the is­sue, how­ever. In a state­ment is­sued Mon­day, Tower Health said the In­de­pen­dence Blue Cross pro­posal in­cluded rate re­duc­tions and a non-com­pete pro­vi­sion in the ser­vice ar­eas of the Tower Health/ UPMC Health Plan Prod­ucts, which Tower Health did not ac­cept.

The health sys­tem and UPMC Health Plan have a joint ven­ture agree­ment to de­velop health cov­er­age and re­lated ser­vices.

A Tower Health spokes­woman said Fri­day that the new 3-year provider agree­ment with In­de­pen­dence Blue Cross does not in­clude a non-com­pete pro­vi­sion.

The new Tower Health sys­tem con­sists of 11,000 em­ploy­ees and a net­work of 2,000 physi­cians, spe­cial­ists and providers across 65 lo­ca­tions.

Pottstown Hos­pi­tal is lo­cated in Pottstown, Phoenixville hos­pi­tal is lo­cated in Phoenixville, Brandywine Hos­pi­tal is lo­cated in Caln Town­ship, Chest­nut Hill Hos­pi­tal is lo­cated in Philadelphia and Jen­nersville Hos­pi­tal is lo­cated in Penn Town­ship in south­ern Ch­ester County. Read­ing Hos­pi­tal is lo­cated in West Read­ing.

Clint Matthews

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