Relationships between health insurers and some of Chicago's most prominent hospitals are undergoing some change, according to a Crain's Chicago Business report.
On the city's South Side, the 20-year relationship between Humana and University of Chicago Medicine will come to an end April 1, when the three-hospital system will be eliminated from the insurer's network. The change will affect approximately 1,750 patients.
A Humana spokesperson told Crain's the contract talks with University of Chicago Medicine "resulted in a difference of opinion with regard to fair and competitive rates for Humana's products," although the insurer will still contract with Rush University Medical Center, Northwestern Memorial and Loyola University Medical Center, all in Chicago.
Blue Cross & Blue Shield of Illinois has notified 65 medical groups that they will face reduced reimbursement, effective Jan. 1, to physicians if they refer BCBS HMO patients to Rush, a four-hospital network. Rush, to avoid this business threat, is cutting its reimbursement rate for those patients. Rush did not specify the amount of the reduction, according to the report.
There are approximately 748,000 BCBS HMO patients in the state, and the majority are in the Chicago area. A Rush spokesperson told Crain's that approximately one-third of 2014 net patient revenue for the network came from Blue Cross, but the HMO program in contention represented just 1 percent of Rush's annual admissions last year.