Empire & Stellaris Reach Pact effective 8/1/10

Empire & Stellaris Reach Pact effective 8/1/10

The showdown is over and 45,000 Westchester Empire Blue Cross residents can now breathe a sigh of relief.  The majority of the Westchester hospitals belong to this network – Lawrence Hospital Center,Northern Westchester Hospital, Phelps Memorial Hospital Center and White Plains Hospital Center.

While these hospitals were covered on emergencies and the physicians were unaffected it still posed an inconvenience.  physicians were rerouting patients to participating hospitals such as Westchester Medical Center in Valhalla.

As I posted in prior blogs these tight negotiations will be the new norm as regional hospital systems have logically evolved to gain leverage in the market.  Unlike in past negotiations this one has been a thriller as contracts have not been renewed since April 1.  The PR campaign was heavy on both sides with political pressures coming down form the State, board of directors and passionate letter writing campaigns.

Ironically we are seeing the opposite trend from insurers who are building smaller networks focused on smaller  regional hospitals and medical centers.  The article in NYT, Insurers Push Plans That Limit Choice of Doctor, discusses how this model may possibly work in the new Obama Care.  Many may be willing to make network concessions with savings of 15%.  We are seeing this trend already with offshoots from insurers such as a 5 Boroughs plan – Aetna NYC HMO, Atlantis and Emblem CompreHealth HMO.  We expect Empire and Oxford to come out with something similar.  Our clients will be closely monitoring these networks.

So in an odd twist a Stellaria Hospital system may be the only hospital a Westchester resident can go to with a possible NYC hospital systems alliance such as Columbia Presbyterian Hospital/New York Cornell.

Either way Empire residents here will be sleeping soundly knowing that they are not limited, for now.