In recent days I have forwarded many e mails from residents who subscribe to Empire Blue Cross BlueShield and Stellaris Health Networks to the CEOs of both organizations and to local hospital presidents. . Because the parties have not yet agreed to a contract those who have Empire Blue Cross/Blue Shield have been denied access to medical services from area hospitals—Northern Westchester, Lawrence Hospital, Phelps Memorial and White Plains Hospital.
Obviously, this has created a tremendous amount of stress for constituents and employees who subscribe to Empire Blue Cross Blue Shield and who have major medical needs. Some people have been forced to delay surgeries and procedures. Others are concerned because the doctors they trust and have used for many years do not have privileges at other hospitals. I have received e mails from patients with leukemia,cancers and major/minor medical problems.
PROGRESS IS BEING MADE.—READ STATEMENTS FROM HEAD OF EMPIRE BLUE CROSS/WHITE PLAINS HOSPITAL
I have spoken with Mark Wagar, CEO of Empire Blue Cross Blue Shield and have e mailed him a number of times this week. His office just sent me the following statement. ALSO posted below is an e mail that a constituent sent to me –from the President of White Plains Hospital.
It’s important that we continue to highlight the personal stories that this contract dispute is having on Empire Blue Cross Blue Shield customers. All e mails that I receive highlighting your experiences are being forwarded to Empire Blue Cross Blue Shield and Stellaris Health Networks. Please e mail me at email@example.com
Greenburgh Town Supervisor
This is the statement we are releasing in response to the emails we are receiving as a result of Stellaris' most recent communications:
We are pleased to report that Stellaris presented us with a revised proposal on Tuesday, July 27, 2010. Stellaris' revised proposal signals a compromise on their request for increased reimbursement and, importantly, indicates a willingness to align payment with value by putting a portion of their reimbursement at risk for achieving quality metrics and reducing readmission rates. This is a positive development for our members and their patients.We are particularly excited about the opportunity to create a collaborative arrangement going forward that promotes improved patient safety and outcomes. Towards that end, we have prepared a counter proposal that we will be presenting to Stellaris at a meeting scheduled for later today (July 30).
Though we have learned that Stellaris has issued a communication informing patients and community leaders that this was their final offer, Stellaris did not state that in their proposal to us. Therefore, we will continue a collaborative dialogue with Stellaris designed to reach an appropriate compromise that balances their needs against the needs of our members for affordable, accessible, quality health care. We believe that Stellaris will do the same and, if that is the case, we are hopeful to bring this negotiations to a successful conclusion soon.
We know that Stellaris Health network is important to our customers and members. Accordingly, we will continue to post updates www.empireblue.com.
Sending on behalf of
Mark Wagar, President & CEO
FROM JOHN SCHANDLER, WHITE PLAINS HOSPITAL
It’s been a few weeks since we last wrote to you about our situation with Empire Blue Cross and we want to take this opportunity to provide you with an update on our negotiations.
Early this week, we presented Empire with a revised offer. In an effort to finally resolve this for the sake of our community, we lowered our request to single digit rate adjustments over three years to meet Empire half way. We offered to accept part of those payments based on quality measures, which Empire wanted, because we are confident in the quality of care we provide. Finally, we offered to partner with Empire to reduce the readmission rate (the percentage of patients who return to the hospital with an infection, complication, or other problem) to reduce the overall cost of care. This would be an innovative partnership that's good for everyone in the health care system. Our latest offer demonstrates a major step toward resolution and we urge Empire to accept our offer and settle this dispute immediately.
The decision is really in Empire's court. We have no room left for movement, and Empire can either reject our offer and continue to disrupt their members' health care needs or accept our new offer and end this dispute. We gave Empire until early next week to respond to our offer, and we are holding them to this timeline. They have a decision to make and we can only hope it’s the right one for the sake of our community, our patients, and their members.
We could use your help. Please contact Empire and urge them to accept our offer and settle this dispute once and for all. They need to hear how important it is that we reach a resolution on this issue and the more pressure they get from their members and the community, the higher the likelihood they will accept. Please call, write, or email today.
Mark Wagar, President & CEO
One Liberty Plaza, New York, NY 10006
We have made every attempt throughout the course of these negotiations to get a contract finished. We’ve lowered our request more than once, we’ve proposed new and creative approaches to payment, we’ve accepted Empire’s request for quality pay for performance, and we’ve offered innovative partnerships with Empire unlike any other. It’s up to Empire to make this right and accept our latest offer and we hope they do.
Thank you again for your continued support and assistance. Please don’t hesitate to call us at (914) 206-4664 with any questions.
Jon B. Schandler
President & CEO
White Plains Hospital Center