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NY-Presbyterian in Negotiations to Stay in Empire BCBS Network; 300K Could be Affected

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New York-Presbyterian is working hard to reach an agreement that will allow it to stay in Empire BlueCross BlueShield’s network. If such a deal cannot be reached by the end of this year, about 300,000 patients could face higher charges next year, according to New York-Presbyterian’s estimates.

New York-Presbyterian is working hard to reach an agreement that will allow it to stay in Empire BlueCross BlueShield’s network.

If such a deal cannot be reached by the end of this year, about 300,000 patients could face higher charges next year, according to New York-Presbyterian’s estimates.

New York-Presbyterian is telling patients all about where the negotiations stand via both a letter and a new website, staywithnyp.org.

“It has been, to us, what appears to be negotiating to terminate,” Dr. Laura Forese, NYP’s executive vice president and chief operating officer, told Crain’s New York. “That’s not where New York-Presbyterian wants to be, and our patients are caught in the middle of that.” Part of the web site FAQ includes this:

“NewYork-Presbyterian is currently negotiating with Empire/Anthem (owned by Wall Street giant Anthem, headquartered in Indianapolis) on a new contract that covers how they pay our hospitals. Our physicians will also be affected. We are negotiating a new contract for all Empire/Anthem lines of business including, commercial (employer-sponsored), NY State of Health Marketplace, Medicare Advantage, and Medicaid insurance health plans. Our negotiations will affect all NewYork-Presbyterian facilities, as well as Weill Cornell Medicine, ColumbiaDoctors, and physicians in NewYork-Presbyterian Medical Groups.

“Contract negotiations between health insurance companies and healthcare providers are a common part of operations, and we started talks with Empire/Anthem well before the contract end date to allow enough time for resolution. Our request is simple. We need Empire/Anthem to recognize the value that NewYork-Presbyterian provides, and to collaborate with us on a fair contract. Our patients, whether they rely on government-subsidized programs like Medicaid or Medicare, or have private insurance, or are underinsured or uninsured, know they can rely on us. Our hospitals in Manhattan, Queens, Brooklyn and Westchester provide more than $1 billion a year in direct benefits to the communities we serve.

“The current contract with Empire/Anthem ends at midnight on December 31, 2018. Until then, nothing changes for our patients with Empire/Anthem health insurance. You can continue to access all NewYork-Presbyterian facilities and Weill Cornell Medicine, ColumbiaDoctors, and physicians in NewYork-Presbyterian Medical Groups as you always have. We are doing everything we can to reach an agreement with Empire/Anthem before our current contract expires on December 31, 2018.

“These negotiations specifically affect our patients with Empire/Anthem health insurance, including those with commercial (employer-sponsored), NY State of Health Marketplace, Medicare Advantage, and Medicaid health plans. And if we are forced out of Empire/Anthem’s network, your in-network access to NewYork-Presbyterian, as well as your trusted physicians at Weill Cornell Medicine, ColumbiaDoctors, and NewYork-Presbyterian Medical Groups will be affected. You could be forced to pay much higher out-of-pocket costs, or have no coverage at all, which may prevent you from getting the high-quality care that you and your family deserve.”

The explanation ends with some finger-pointing: “Instead of working with us to find an equitable solution, Empire/Anthem has demanded deep cuts that would slash more than $200 million in payments to NewYork-Presbyterian, all while the insurance giant generates billions in profits. We need Empire/Anthem to recognize the value that NewYork-Presbyterian provides and to collaborate with us on a fair contract. Our patients, whether they rely on government-subsidized programs like Medicaid or Medicare, or have commercial insurance, are underinsured or uninsured, know they can rely on us. Our hospitals in Manhattan, Queens, Brooklyn and Westchester provide more than $1 billion a year in direct benefits to the communities we serve.”

By Patricia Savage

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