Scott & White Health Plan Changes
Statement in Reply to Scott & White Health Plan Contract with The Med
Bryan, TX (January 23, 2012) - Although St. Joseph has not been notified by Scott & White Health Plan of any changes to our hospital contract, news reports indicate the Health Plan has entered into an agreement with College Station Medical Center. According to a release, the agreement would make College Station Medical Center an in-network provider for patients with Scott & White insurance beginning February 1.
Based on the limited information available, this contract appears to be a breach of the exclusive hospital contract currently in place between Scott & White Health Plan and the St. Joseph Health System. Because St. Joseph was not informed of SWHP's intent to breach the contract before the media announcement, St. Joseph has contacted a representative of the Health Plan for additional information. The exclusive contract between St. Joseph and SWHP will expire April 30, 2012. In November, St. Joseph informed Health Plan executives that St. Joseph would honor the contract through April 30, 2012, to avoid inconvenience to local patients and physicians.
As it always has, St. Joseph is honored to care for patients who are covered under SWHP. Additionally, we continue to care for patients who see Scott & White physicians, but are covered by other insurance. Scott and White's College Station Clinic physicians are members of St. Joseph's medical staff and continue to admit patients at St. Joseph Regional, expecting excellent care. We continue to deliver award-winning care to patients as we have for 75 years, and encourage patients who prefer to use St. Joseph for reasons of quality or convenience to discuss that with their physician and express their preference.
We regret that SWHP's actions today leave patients, physicians, and St. Joseph with uncertainty over where Scott & White Health Plan patients are to be cared for in the coming months. St. Joseph continues to have an agreement to be the exclusive provider of hospital services for the Scott & White Health Plan until April 30, 2012, and will honor that commitment.
Frequently Asked Questions for Scott & White Health Plan patients
Scott & White made the decision to move from being our partner to our competitor by building a hospital in College Station. We wish them well in that endeavor. However, it is St. Joseph's responsibility to continue our mission in the Brazos Valley, consistent with our tradition and values, as we have done for the past 75 years. We have decided to focus on health plan relationships that allow patients to choose unrestricted access to St. Joseph physicians and hospitals.
St. Joseph had two contracts with Scott & White Health Plan. One was a three-year contract for physician services that Scott & White Health Plan allowed to expire on August 31, 2011. The other is a three-year exclusive contract with Scott & White Health Plan for inpatient hospital services, which expires April 30, 2012. We do not intend to renew either the expired physician contract or our exclusive contract for hospital services when it expires. St. Joseph is honored and grateful for the opportunity to provide award-winning care to residents of the Brazos Valley who come to St. Joseph for their healthcare needs. In the future, those who have Scott & White insurance will have to do so on an out of network basis.
If you have any questions about this decision, please contact email@example.com or call (979) 774-2161.
Insurances Accepted at St. Joseph Regional Health Center
Insurances Accepted at St. Joseph Physician Associates, Rural Clinics and Walk-In Clinics
Contract Expiration Statement
We would like to clarify the misunderstanding regarding the notice to Scott & White Health Plan members on the expired St. Joseph medical group contract.
At several meetings held this summer between St. Joseph representatives and Scott & White Health Plan (SWHP) representatives, St. Joseph expressed concerns about signing any contracts with the Health Plan given that Scott & White was building a hospital in College Station that would directly compete with St. Joseph. During these meetings, St. Joseph managed care representatives pointed out that the contract between the St. Joseph medical group and the SWHP would expire August 31, 2011. Scott & White Health Plan leaders acknowledged the physician contract was ending in August and was up for renewal. The terms of the contract required SWHP to notify St. Joseph of their intent to renew that contract at least 60 days before it expired. St. Joseph never received notification of SWHP's intent to renew the physician contract.
Once Aug. 31 passed, with no new contract in place with the St. Joseph medical group, insurance regulations required SWHP to notify its members of the change in network providers, which did not happen.
On Monday, Nov. 7, St. Joseph representatives met with SWHP representatives and notified them that St. Joseph would not renew the contract between the Hospital and SWHP when it expires on April 30, 2012. At that meeting we reminded SWHP representatives that they allowed the physician contract to expire and that we would not consider a new contract with the St. Joseph medical group. We can't be both a partner and a competitor.
We apologize for any confusion experienced by Scott and White Health Plan members over the expiration of the St. Joseph medical group contract. St. Joseph medical offices are not turning away patients with Scott and White insurance, but have been informing patients that we are out-of-network and we recommend they call the SWHP offices to find out how their care will be covered. We are doing this so that SWHP patients can avoid being subject to possible higher out-of-pocket fees since St. Joseph physicians are not in the SWHP network.
St. Joseph values the strong relationship we have built with Scott & White Clinic - College Station and respects the Clinic physicians and staff. We will continue to work with them in helping patients get the care they need every day. Both organizations are working to make sure the health needs of those covered by Scott & White insurance are being met.
FOR IMMEDIATE RELEASE
November 8, 2011
Questions: Call (979) 774-2161 or firstname.lastname@example.org
St. Joseph Announces Contract Changes with Scott & White Health Plan
Bryan, TX (November 8, 2011) - Yesterday, St. Joseph notified Scott and White Health Plan of its intent not to renew a hospital services contract that expires April 30, 2012. This decision comes after much discussion among physicians and St. Joseph board members, as well as analysis completed following Scott & White's announcement to build a local hospital.
On August 31, Scott & White Health Plan leaders allowed their in-network provider contract with St. Joseph's physician medical group, St. Joseph Physician Associates (SJPA), to expire. This means more than 50 St. Joseph physicians and specialists are now out-of-network for people with Scott & White insurance.
"Although we appreciate the opportunity to provide care for patients with Scott & White insurance, after lengthy internal discussions and consideration, we have decided not to renew our hospital services contract with the health plan," said Tony Pfitzer, President and CEO of St. Joseph. "A local Scott & White hospital will compete with St. Joseph for patients and St. Joseph cannot be both a partner and a competitor."
It's important for residents to know St. Joseph will not be negotiating a new hospital or physician contract with Scott & White Health Plan. "Instead, we will focus our efforts on making sure patients with Scott & White insurance have as much notice as possible so they can make appropriate plans for their healthcare," said Tim Ottinger, St. Joseph Vice President of Community Relations. "St. Joseph is happy to continue seeing patients with Scott & White insurance but we want people to know the Scott & White Health plan may not support them seeing a non-network provider."
This announcement does not affect any of the other commercial insurances St. Joseph contracts with, including Blue Cross/Blue Shield, Aetna, Cigna, United Healthcare, FirstCare and more than a dozen others. It does not affect anyone covered by Medicare or Medicaid, but could affect those with Scott & White Medicare supplemental health insurance coverage. Below is a document listing all insurances accepted at St. Joseph.