health
5:04 pm
Fri January 6, 2012

Blues, Beaumont reach settlement, avoid booting HMO patients

Blue Cross-Blue Shield of Michigan has reached a five-year deal with Beaumont Health System that will increase reimbursements to the hospital. It also includes a new performance-based payment model.

The health system had threatened to stop accepting patients covered by the Blues’ HMO, Blue Care Network,  starting next Thursday. 

"It was very unfortunate but the good news is that we’ve rescinded that now, and BCN members will not have gone one day without their services being covered at Beaumont and we think that’s a very positive outcome,"  said Beaumont CFO Nick Vitale.

Officials on both sides say the deal will better coordinate care by establishing programs that avoid unnecessary tests "to make sure that the primary care physicians are speaking to the specialists who are speaking to the hospitals to make sure that if there’s a test performed that it’s only performed once," said BCBSM vice president Sue Barkell.

The five-year contract will boost reimbursements to the hospital. But the two sides would not disclose what the rate increase will be.