Here is the story from ABC 27 News, a local affiliate in Harrisburg, PA. The expansion will make 500,000 more residents in PA eligible for Medicaid.
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The current provider contract between Cigna-HealthSpring and Crozer-Keystone Health System (CKHS) is set to expire on April 30th, 2014 and it appears that the sides are fairly far apart in their negotiations. It’s not uncommon, however, for these contract disputes to run right up to the last minute, however, CKSH has posted a message on their website.
CKSH has provided services to a relatively small percentage of Cigna-HealthSpring members in the past 12 months, roughly 4,300 of their 70,000 members. Cigna-HealthSpring payments represent about 4% of CKSH’s revenues.
Cigna-HealthSpring commented that they are keeping lines of communication open with CKSH.
It’s not 100% clear to me if this impacts primary care doctors and specialists, or only the CKSH facilities. In the letter to Cigna-HealthSpring members, CKSH seems to indicate that the doctors are part of the termination (“our physician practices’ participation with Cigna HealthSpring is also terminated effective April 30, 2014.”), however, Cigna-HealthSpring’s perspective was that the PCP’s and specialists were not a part of the contract ending 4/30/14.
Here is a link to the article from Philly.com. Health Partners Plans (formerly Health Partners of Philadelphia Inc.) operated Medicare advantage plans 6 years ago which were sold to Elder Health (which moved to Bravo, then HealthSpring and now Cigna HealthSpring). They have now filed with CMS for new plans for 2014.
Here is the story from the Pittsburgh Tribune-Review. Highmark is the largest health insurer in Pennsylvania and an affiliate of the BlueCross and BlueShield Association. The closing of the deal with Jefferson, valued at $350 million, gives Highmark an anchor hospital in the South Hills of Pittsburgh. Highmark is also trying to finalize an approximately $1.1 billion acquisition of the West Penn Allegheny health system. The West Penn deal is pending regulatory approval of the PA State DOI.
In unveiling his budget, PA Governor Tom Corbett revealed that PA will not participate in Medicaid expansion in its current form, but seemed open to compromise on this issue. Here is the story for the Patriot News in Harrisburg, PA.
Highmark is selling off their Medicare claims processing business in order to clear a regulatory path regarding their acquisition of West Penn Allegheny. It appears that Highmark is more interested in vertical expansion within the health care space than growing horizontally with ancillary Medicare service businesses. A Highmark EVP is quoted as saying that they plan to expand more into the medical provider business.
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