Here are 11 recent issues that occurred between hospitals, health systems and payors within the past month, starting with the most recent.
1. Anthem Blue Cross in California shut out two of the largest healthcare providers in the Los Angeles area — Cedars-Sinai Medical Center and UCLA Health System — from its health plan for city employees because the health systems are "too expensive."
2. Regulators at the Massachusetts Division of Insurance gave the OK for Boston-based Partners HealthCare to acquire Neighborhood Health Plan — the first health plan Partners has acquired.
3. Pittsburgh-based health insurer Highmark said it will launch a new health plan, Community Blue, in western Pennsylvania starting Jan. 1, but most University of Pittsburgh Medical Center hospitals and physicians will be considered out-of-network.
4. Coordinated Health – Bethlehem (Pa.) and Pittsburgh-based health insurer Highmark ended their contract after the two sides could not negotiate new payment rates.
5. St. Luke's Health System in Boise, Idaho, formed a partnership with SelectHealth, a health plan part of Salt Lake City-based Intermountain Healthcare, to offer new value-based health insurance benefits to Idaho residents.
6. California Senate Bill 359, which would limit the charges of a hospital's out-of-network emergency department plan, passed both the Senate and Assembly and now awaits the signature of Gov. Jerry Brown.
7. Nashville, Tenn.-based Vanguard Health Systems, Boston-based Tufts Medical Center and the New England Quality Care Alliance — a non-profit physician network of Tufts with 1,600 physicians — announced they will sponsor a Consumer Operated and Oriented Plan.
8. Iowa Health System in Des Moines and Henry Ford Health System in Detroit both finalized agreements with Meridian Health Plan, a physician-owned Medicaid HMO.
9. Marietta, Ga.-based WellStar Health System signed a three-year agreement with health insurer Aetna.
10. Charlotte, N.C.-based Novant Health and health insurer Aetna reached a multiyear contract, ensuring Novant's 13 hospitals and several clinics stay within Aetna's network.
11. Franklin, Tenn.-based Community Health Systems and Arkansas BlueCross BlueShield reached a new agreement on reimbursement rates.
1. Anthem Blue Cross in California shut out two of the largest healthcare providers in the Los Angeles area — Cedars-Sinai Medical Center and UCLA Health System — from its health plan for city employees because the health systems are "too expensive."
2. Regulators at the Massachusetts Division of Insurance gave the OK for Boston-based Partners HealthCare to acquire Neighborhood Health Plan — the first health plan Partners has acquired.
3. Pittsburgh-based health insurer Highmark said it will launch a new health plan, Community Blue, in western Pennsylvania starting Jan. 1, but most University of Pittsburgh Medical Center hospitals and physicians will be considered out-of-network.
4. Coordinated Health – Bethlehem (Pa.) and Pittsburgh-based health insurer Highmark ended their contract after the two sides could not negotiate new payment rates.
5. St. Luke's Health System in Boise, Idaho, formed a partnership with SelectHealth, a health plan part of Salt Lake City-based Intermountain Healthcare, to offer new value-based health insurance benefits to Idaho residents.
6. California Senate Bill 359, which would limit the charges of a hospital's out-of-network emergency department plan, passed both the Senate and Assembly and now awaits the signature of Gov. Jerry Brown.
7. Nashville, Tenn.-based Vanguard Health Systems, Boston-based Tufts Medical Center and the New England Quality Care Alliance — a non-profit physician network of Tufts with 1,600 physicians — announced they will sponsor a Consumer Operated and Oriented Plan.
8. Iowa Health System in Des Moines and Henry Ford Health System in Detroit both finalized agreements with Meridian Health Plan, a physician-owned Medicaid HMO.
9. Marietta, Ga.-based WellStar Health System signed a three-year agreement with health insurer Aetna.
10. Charlotte, N.C.-based Novant Health and health insurer Aetna reached a multiyear contract, ensuring Novant's 13 hospitals and several clinics stay within Aetna's network.
11. Franklin, Tenn.-based Community Health Systems and Arkansas BlueCross BlueShield reached a new agreement on reimbursement rates.
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