Southampton Hospital —Â and the two other local medical facilities that are part of the East End Health Alliance — successfully negotiated an agreement with two insurance providers on Friday, September 19. The Alliance had issued a press release on Monday announcing that subscribers to both GHI and HIP —Â which are presently in the process of merging — would soon be out of network. Friday’s negotiation, however, narrowly made the deadline and prevented the change in protection.
On Wednesday, negotiators from the Alliance were in a telephone conference to try to meet a midnight Friday deadline with HIP, whose contract was set to expire with Southampton Hospital and Peconic Bay Medical Center in Riverhead. If negotiations failed, then patients with HIP who normally receive care at those two hospitals would have needed to find other institutions if they hoped to be covered by their insurance. Patients already scheduled for procedures, as well as emergency cases, Â would still have been covered.
Ilene Margolin, a spokesperson for both GHI and HIP,Â Â declined to elaborate on the companies’ positions, saying “we don’t negotiate in the press.”
At issue, according to Paul J. Connor, spokesman for the Alliance, was the amount the hospitals are reimbursed from the insurance companies for care they give.
“It doesn’t cost any less to care for a patient here than it does at any other hospital on Long Island,” said Connor this week.
“It is critical to quality patient care at our East End hospitals that our insurance reimbursement rates keep pace with the costs of providing patient care,” Mr. Connor explained. “As with all hospitals, our costs including pharmaceutical, utility and labor expenses, continue to increase significantly.”
The negotiations also included GHI. Both HIP and GHI have the same parent company, Emblem Health. The out-of-network deadline for Peconic Bay Medical Center and Southampton Hospitals for GHI was October 5, 2008. Eastern Long Island Hospital’s out-of-network deadline for HIP and GHI was November 13.
The three hospitals in the Alliance — which formed earlier this summer after several years of fits and starts with another, failed, relationship — have been attempting to have their various contracts with insurance providers all on the same schedule with each other. Earlier this year they successfully negotiated new contracts, also fighting over more equitable reimbursements, with Empire Blue Cross, Oxford and United Health Care. The managed care agreement hammered out on Friday will for two years.
“This will be the last of the major insurers for this year,” said Connor. Blue Cross will come up again next year, he said, but it is the goal of the Alliance to have all of the contracts extended to two years each.