The Daily Item, Sunbury, PA

April 25, 2013

CEO: Highmark's claims about Geisinger value wrong

By Robert Stoneback
The Danville News

DANVILLE — A new health plan offered by Highmark misrepresents the quality of care offered by Geisinger Medical Center, according to Geisinger Health System’s CEO and authority board.

Under Highmark’s new Community Blue Premier Flex program, Geisinger Medical Center is considered a “standard value” instead of an “enhanced value” medical provider, a designation that comes with out of network care costs for plan holders.

“The impact of Highmark’s designation treats Geisigner as if we were ‘out of network’ for people whose employers purchase Community Blue Premier Flex, and forces them to pay more to receive care from Geisinger,” said Geisinger Health Systems CEO and President Glenn Steele, in an advertorial that recently ran in local newspapers.

“Highmark’s marketing materials for Community Blue Premier Flex would lead you to believe that Geisinger is not an ‘enhanced value’ provider because we are not as high quality as the providers in their ‘enhanced value’ tier,” wrote Steele. “That’s not only hard to believe; it’s wrong.”

Members of the Geisinger Authority board voiced strong agreement with Steele at their April 24 meeting.

“In the region where Highmark has introduced this product, there is no hospital, none, that has the breadth and scope of our tertiary services, our complex healthcare services,” said Kevin Brennan, Chief Financial Officer and Executive Vie President for Finance for Geisinger Health System.

Forcing regional customers to travel beyond Geisinger to find in-network care is “a real distance and a burden for people. We think that’s inappropriate, inconvenient, insensitive and we think it’s wrong,” said Brennan. “That’s why we’re coming out so strongly with Dr. Steele’s message here.”

He advised local employers not to accept the new plan as it could easily result in their employees paying more to receive local treatment at Geisinger.

Brennan and Steele both cited several accolades, past and present, bestowed on Geisinger Medical Center, including receiving the Thompson Reuters Top 100 Hospitals National Benchmarks Awards for the eighth time in 2012, as well as being noted for its safety nursing care. Steele also made note how the national Blue Cross and Blue Shield Association, of which Highmark is a member, has recognized GMC more times than any other regional hospital with its “Blue Distinction Center” for specialty care expertise.

“Any attempt to insult a product in this manner is inappropriate,” said Brennan.

He compared the situation faced by Geisinger to those smaller hospitals might be put through.

“Quite frankly, many of these small hospitals really don’t have the size of network and coordinating capabilities we have and frankly don’t have the ability to ever object strongly to any contract offering that someone with Highmark with all their clout makes. We think they really take advantage of those facilities,” said Brennan.

A call has already been placed by Geisinger executives to Highmark’s CEO to discuss the matter. “I’ve left the door open for a resolution,” said Brennan.

Dave Jolley, Geisinger Health System’s vice president for system public affairs, did not think the matter was related to Highmark’s recent interest in purchasing healthcare systems. Highmark is currently in the planning stages of an acquisition of West Penn Allegheny Health System of Pittsburgh.

“I’m not sure it’s related…it’s just the introduction of a new product,” said Jolley.

“I don’t know their motive, I would be speculating,” said Brennan, when asked on the topic.

Currently, eight percent of Geisinger Health System’s patients are on a plan offered through Highmark, with most of those patients being treated in the Geisinger Medical Center region, said Jolley.

 

Email questions or comments to rstoneback@thedanvillenews.com.