Tenet Healthcare Corporation will no longer be entering into Connecticut to acquire five hospitals, according to a statement released by Tenet and Gov. Malloy. Both sides have failed to come to an agreement and have ended negotiation talks. The news comes after Tenet and the Malloy Administration promised in January to revive the deals. Tenet has spent two years trying to make the acquisitions, which included Waterbury, St. Mary’s, Bristol, Manchester Memorial, and Rockville General hospitals. In a statement, Malloy said “the environment for both providers and state governments is complex and rapidly changing. Unfortunately, the issues that separated us simply could not be overcome.”
Tenet Healthcare has officially pulled the plug (for now) on its acquisition of four Connecticut hospitals. Tenet notified government officials that it would not continue its pursuit of buying Waterbury Hospital, St. Mary’s Hospital, Bristol Hospital, and Eastern Connecticut Health Network to convert them from non-profit hospitals to for-profit ones. Tenet cites the extensive list of proposed conditions as reasons for pulling out of the four transactions. Tenet’s decision has widespread impact on Connecticut’s healthcare industry and also creates a political problem for Governor Dannel P. Malloy and his state legislature. Connecticut hospitals were depending on Tenet for capital to remain economically viable long-term and now may need to find other partners or ask the state legislature for funding increases.
Late last week, Anthem Blue Cross and Blue Shield and Hartford HealthCare announced that they had reached an agreement on a new contract, allowing the five hospitals under Hartford Healthcare to return to the insurer’s network. As we previously reported, Anthem and Hartford HealthCare were unable to reach a deal before their contract expired. A joint statement released by the two companies did not disclose specific details of the new contract. However, it say it was a multi-year agreement and that the hospitals’ return to Anthem’s network was effective October 1. A main sticking point for Anthem was its focus to tie more of the hospitals’ pay to performance, part of a movement in healthcare to reward providers based on patient outcomes and care quality. The new agreement will also broaden an existing program aimed at improving coordination of patients’ care. The companies also plan to “implement a chronic care program for patients with complex conditions and work on ways to integrate behavioral healthcare into Hartford HealthCare’s primary care settings.”
As the midnight deadline passed, Anthem Blue Cross and Blue Shield and Hartford HealthCare failed to reach an agreement on contract terms. Starting today, Anthem and Hartford will face higher, out-of-network rates for services at Hartford HealthCare hospitals, and will be forced to seek medical attention elsewhere. Anthem spokespeople have said the main sticking point was payment increases in the first year of the new contract, saying Hartford wants a 100 percent guaranteed increase. Anthem, on the other hand, wants a combination of guaranteed increases and dollars paid based on the network’s performance. If negotiations fail for another month, more facilities, including Natchaug Hospital, Rushford Center mental health and addiction services, VNA Healthcare, Southington Care Center rehabilitation clinic and Jerome Home will all be out of network. Hartford HealthCare has already sent letters to 104,500 people who have Anthem coverage and have been patients in the past 12 months, warning them they would be out of network if no agreement is reached. Some hospital procedures, such as emergency care, will still be charged at in-network rates.
As of this afternoon, the state’s largest health insurer, Anthem Blue Cross Blue Shield and a network of five major Connecticut hospitals, Hartford HealthCare, have yet to reach an agreement. Anthem and Hartford are continuing to negotiate contract terms; the existing contract expires at midnight tonight. If the contract expires, Anthem’s network will no longer include Hartford Hospital, The Hospital of Central Connecticut in New Britain, MidState Medical Center, William W. Backus Hospital, and Windham Hospital. Many similar disputes have been resolved near the contract deadline.
Stay tuned to the HMS blog for the latest information regarding this negotiation.
In lieu of the November 15 start date of the next insurance enrollment period, Connecticut’s exchange is planning an in-person outreach effort-but it’s only a fraction of last year’s nearly $3 million sign-up blitz. Although the outreach plan is still in draft form, critics say it’s inadequate for reducing the number of uninsured residents in the state. The plan calls for using six agencies to serve as the mobile enrollment and education centers during the sign-up period. The draft also calls for a year-round assistance program to help people understand how to use their coverage. One of the primary reasons for this dramatic reduction in funds is due to the fact that there are no federal funds available this year to support the efforts. Experts say this year will be more complicated, with the “dual challenge of keeping existing members insured while trying to reach the remaining uninsured, who could be harder to persuade to get coverage.”
Connecticut and New York have reported possible cases of Enterovirus D68, a respiratory illness that is suspected of hospitalizing hundreds of children in 21 states in the South, Midwest and now Northeast. New York was the first state on the East Coast to report cases of the virus which attacks children, especially those with asthma. Enteroviruses are pretty common and the CDC estimates that 10 to 15 million people are infected with them each year. However, the Enterovirus D68 strain dates back to 1962 and hasn’t been widely reported in years which experts believe is part of the problem. This particular strain causes severe respiratory disease and there are currently no available vaccines or specific treatments for the virus. Symptoms typically look like those of the common cold but then can lead to difficulty breathing and wheezing. Experts say it is important to follow common sense rules such as practicing proper hygiene to prevent the spread of the virus.
Access Health CT, Connecticut’s online insurance exchange, has named James R. Wadleigh Jr. as interim CEO. Wadleigh is currently Access Health CT’s chief information officer; he begins his new role tomorrow. Earlier this week, Access Health’s current CEO Kevin Counihan announced he was resigning to lead the federal government’s insurance exchange, HealthCare.gov. Wadleigh has served as chief information officer since 2012 and has spent 25 years in information technology across multiple insurance industries, including healthcare, property casualty, life insurance and annuities.
Kevin Counihan, CEO of Connecticut’s health insurance exchange, Access Health, is resigning to lead the once-troubled federal exchange, HealthCare.gov. Since 2012, Counihan has led Connecticut’s exchange which sells private insurance plans and enrolls people in Medicaid. The board overseeing the Connecticut exchange will appoint an interim CEO in the meantime and conduct a national search for Counihan’s replacement. Access Health has been one of the nation’s better-performing exchanges. In recent months, Access Health has been marketing its system to other exchanges as an alternative to building their own marketplaces from scratch. Currently, thirty-four states use the federal government to full or partially run their exchanges.
According to research findings released Wednesday by Connecticut’s health insurance exchange, the number of people without health insurance has decreased 50 percent since 2012. The state-run online health insurance marketplace created under the ACA called Access Health CT has enrolled more than 256,000 state residents in private health plans and Medicaid since its launch. The percentage of state residents without health coverage dropped from 7.9 percent to 4 percent since the start of the open enrollment period. The Access Health CT data is consistent with a Gallup poll which found that states that set up their own health insurance marketplace and also chose to expand Medicaid had the most significant reductions in the uninsured population.