Op-ed: BlueCross BlueShield excludes Catholic Health facilities

Wed, Nov 5th 2014 03:00 pm

With the open enrollment period for Western New York seniors to choose their health care coverage for 2015 currently underway, Catholic Health is alerting area residents about important changes implemented by BlueCross BlueShield of Western New York to their Medicare Advantage offerings.

A new product being offered by BlueCross BlueShield of Western New York, called Senior Blue HMO Select, completely excludes all Catholic Health facilities. This means that, seniors who enroll in this plan would not receive benefits for non-emergency services provided at all Catholic Health sites, including Kenmore Mercy Hospital, Mercy Hospital of Buffalo, Sisters of Charity Hospital and its St. Joseph Campus, as well as all labs, diagnostic testing facilities, the Mercy Ambulatory Care Center and Catholic Health Home Care.

BlueCross BlueShield did not consult Catholic Health about the decision to exclude our facilities and we are deeply concerned that they have not adequately communicated this change to consumers. In a recent notice to Medicare Advantage participants, they referenced only a "tailored network of facilities" and did not expressly convey the fact that the plan would eliminate the patient's ability to choose Catholic Health facilities for their care.

We think it is important for our seniors to understand this dramatic change in BlueCross BlueShield's benefits. Eliminating access to the region's second largest health care system severely limits options for you and your physician. We also want you to know that you do have a choice.

The good news is that there are several other Medicare Advantage plans available that enable you to continue to receive care from Catholic Health. These competing plans are offered by virtually every other insurance provider in the region.

Although well within their right to do so, we are disappointed in BlueCross BlueShield's decision to exclude Catholic Health's facilities, especially in light of the outstanding results we've achieved in coordination with the physicians at Catholic Medical Partners. Working together through the Catholic Medical Partners Accountable Care Organization, we reduced health care expenditures for Medicare patients by 7 percent from the national benchmark, saving more than $27 million, while also demonstrating high levels of quality in areas including patient safety, care coordination and preventive health.

Health insurance can be complicated enough, and we know that balancing cost and care is an important issue for everyone, especially for seniors who rely on the physicians and facilities they trust. Catholic Health representatives are available to help you understand the choices available to you, so that you can make the best, most informed decision possible for your health care.

For information call 716-923-9790 or visit www.CHSMedicareOptions.org.

Joseph McDonald is president and chief executive officer of Catholic Health.


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