United Physicians, a 2,386-member physician group based in Bingham Farms, Mich., may depart from Southfield, Mich.-based Beaumont Health and its clinically integrated network, Beaumont Care Partners, Crain's Detroit Business reports.
Here are five things to know.
1. The possible fallout stems from a narrow network contract between eight-hospital Beaumont and Priority Health, a Grand Rapids, Mich.-based health insurer. In mid-September, Beaumont signed an amendment to its agreement with Priority Health to participate in a narrow network plan on the ACA exchange. United Physicians was not a part of Beaumont Health's existing agreement with Priority Health, and the system "had no way of including them in the narrow network," Colette Stimmell, vice president of communications at Beaumont, told Becker's. "We are currently working to move the Priority Health contract through the BCP approval process which would allow United Physicians to participate."
2. Michael Williams, MD, CEO of United Physicians, told Crain's Detroit Business his organization was unaware of the contract negotiations. Ms. Stimmell told the publication BCP did not have a lot of time to finalize a contract with Priority Health ahead of the insurer's deadline to offer coverage on the ACA's exchange. BCP comprises Beaumont's hospitals and roughly 2,500 of the system's 5,000 physicians.
3. Dr. Williams told Crain's Detroit Business he notified BCP Interim Executive Director Ryan Catignani that United Physicians is in the process of leaving BCP. Mr. Catignani acknowledged the potential change to Beaumont physicians in a Dec. 1 letter.
4. "Although the parties have been working cooperatively to formalize this change, the normal BCP approval processes for contracts, including the Priority Health contract, has been suspended as a result," Mr. Catignani said. He added once legal processes are finalized and BCP is restructured, "the Priority Health network will be available to all physicians in the BCP network, which includes essentially all physicians in" United Physicians.
5. Dr. Williams did note the physician group is contemplating a final decision and a compromise could be reached, Crain's Detroit Business reports. For its part, Beaumont said the issue is a misunderstanding and Beaumont values its independent physicians. "It is important to note that any physician credentialed and in good standing on Beaumont's medical staff is eligible for participation in the narrow network — even if they are not part of BCP," Ms. Stimmell told Becker's.
For the full Crain's Detroit Business report, click here.
Editor's note: This article was updated Dec. 18 at 2:50 p.m. CT with commentary from Beaumont Health.
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