Published: September 22, 2008 03:52 pm            

Conemagh, Highmark announce settlement

The region’s largest health system has settled its differences with the largest medical insurance provider, ending a nearly-three-month forced contract extension.

Conemaugh Health System and Highmark Blue Cross Blue Shield jointly announced Monday the new three-year contract that provides Highmark members access to all Conemaugh facilities.

“We feel that we have come to an agreement that is fair and beneficial for everyone involved,” Conemaugh President and Chief Executive Officer Scott Becker said.

The health system and insurance company were at odds regarding reimbursement rates, or what Highmark pays for various procedures and treatments. The previous contract expired at the end of June, but the state Insurance Department stepped in and ordered a six-month extension.

“The new agreement demonstrates the commitment of both organizations to continuing our long-standing relationship,” Highmark President and CEO Ken Melani said.

Conemaugh Chief Financial Officer Edward DePasquale said the contract assures stability through the contract period.

“I think both sides feel like they compromised,” DePasquale said. “The rate allows us some predictability over the next three years.”

As part of the agreement, Conemaugh will participate in Highmark’s pay-for-performance initiative, QualityBlue.

“It looks at things like reduction in certain hospital acquired infections, medical technology implementation and surgical care measures for improved patient care,” Highmark spokesman Aaron Billger said.

A company study suggests that by participating in QualityBlue, hospitals elsewhere saved between $32.8 million and $52 million last year by preventing central blood line infections, a Highmark news release said.

        

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