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Regional Payer-Provider Dispute Could Prove Unhealthy
UniNet and BCBS of Nebraska are negotiating over the renewal terms of a contract that is to expire end of August. Failure of talks could leave several hospitals and physicians out-of-network for Blue Cross members.
A regional payer-provider dispute over costs and value is showing that troubles can arise amid efforts to design reforms and move away from fee-for-service.
Blue Cross Blue Shield of Nebraska is headed to a stalemate with the multi-state health system Catholic Health Initiatives, facing an end-of-of-the-month deadline to renew a contract for CHI’s UniNet physician and hospital network.
The disagreement is centered on the contract with UniNet, a physician-led network of 2,000 doctors and 30 hospitals created in 1998 and now sponsored by CHI, after its acquisition of the 11 hospital Alegent Creighton Health — but it has come to include other CHI facilities across the state.
Failure to reach an agreement with UniNet physicians could leave a number of CHI hospitals and many employed and independent physicians out-of-network to Blue Cross commercial members in greater Omaha.
BCBSNE argues that UniNet and CHI are seeking to continue reimbursements that are far higher than peer providers, while CHI maintains that the insurer is pushing unfairly for “deep cuts” and ignoring reasonable options.
“We still want to reach an agreement and keep CHI Health doctors and hospitals in our network,” BCBSNE senior vice president Lee Handke said in a media release. “But unless they get serious about addressing their high costs in the Omaha market relative to other providers here, I’m not optimistic we will get a deal done by the August 31 deadline.”
Read the complete article here: http://bit.ly/1tDljGM
Source: Healthcare Payer News
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
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Government agencies have created an online portal for the public to report potential anticompetitive practices in health care; there are changes coming to the “boxed warning” section for chimeric antigen receptor T-cell therapies (CAR T) to highlight T-cell blood cancer risk; questions about the safety of obesity medications during pregnancy have arisen in women on them who previously struggled with fertility issues.
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Making Giant Strides in Maternity Health Through Baby Steps
April 9th 2024To help celebrate and recognize National Minority Health Month, we are kicking off a special month-long podcast series with our strategic alliance partner, UPMC Health Plan. Welcome to our first episode, which is all about the Baby Steps Maternity Program and its mission to support women throughout every step of their pregnancy journey.
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Gene, Light Therapy Combo Shows Promise Against Prostate Cancer Cells in Proof-of-Concept Study
April 18th 2024In their preclinical model, the researchers found efficacy both in vitro and in vivo by using CRISPR-Cas9 to mimic porphyria and combining the technology with light therapy.
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