LAFAYETTE, Ind. — The Sisters of St. Francis Health Services Inc. and Anthem Blue Cross and Blue Shield in Indiana inked a new multi-year contract on August 31st, one day ahead of the September 1st expiration date on the previous contract. This new agreement will maintain in-network health care benefits for policyholders and employer groups throughout Indiana.

Health insurance plans covered are Anthem Blue Access PPO, Anthem Blue Preferred HMO, Anthem Traditional, Anthem Medicare Advantage PPO, Lumenos, Hoosier Healthwise (Indiana Medicaid) and Anthem Healthy Indiana Plan.

The agreement covers the following SSFHS medical facilities and physicians:

• St. Elizabeth Regional Health in Lafayette;
• Home Hospital in Lafayette;
• St. Clare Medical Center in Crawfordsville;
• St. Francis Hospital & Health Centers in Indianapolis;
• St. Francis Hospital & Health Centers in Beech Grove;
• St. Francis Hospital & Health Centers in Mooresville;
• St. Anthony Medical Center in Crown Point;
• St. Anthony Memorial Health Center in Michigan City;
• St. Margaret Mercy Healthcare Center in Hammond;
• St. Margaret Mercy Healthcare Center in Dyer;
• Franciscan Physicians Hospital in Munster;
• Indiana Bone and Marrow Transplantation Unit in Beech Grove; and
• More than 300 physicians throughout the SSFHS service areas.

Health insurance plans covered are Anthem Blue Access PPO, Anthem Blue Preferred HMO, Anthem Traditional, Anthem Medicare Advantage PPO, Lumenos, Hoosier Healthwise (Indiana Medicaid) and Anthem Healthy Indiana Plan.

“We recognize how difficult this has been for our patients and appreciate their support and patience during the negotiations,” said Jay Brehm, SSFHS regional chief financial officer and chief negotiator for the hospital system. “The agreement we have forged, in the end, ensures our mission to provide patients with the timely and compassionate care they expect and deserve.”

“We are pleased to have reached this agreement with Sisters of St. Francis Health Services because it ensures that our customers will have uninterrupted, in-network access to medical care at SSFHS facilities across Indiana,” said David Lee, M.D., vice president of health services for Anthem Blue Cross and Blue Shield. “This contract achieves our number one goal of keeping health care affordable for our members.”

LAFAYETTE, Ind. — The management team and physicians of Lafayette, Ind. based Unity Healthcare have voted to terminate their contract with Anthem Blue Cross Blue Shield effective January 1, 2010. The decision was in response to Anthem’s proposal that includes significant cuts to reimbursement rates to Unity Healthcare providers. Approximately 60,000 Greater Lafayette residents will be affected by this change.

Unity says that in an environment of physician and nurse shortages, reimbursement rates are key to establishing and maintaining a high quality healthcare system.

“Decreasing reimbursement rates will have a direct, negative effect on our ability to invest in quality physicians, staff, new technologies and infrastructure,” said Gary Prah, M.D., President of Unity Healthcare. “Anthem’s proposal, combined with our region’s current physician shortage, may force patients to pay out-of-network penalties, wait longer to see a physician and increase the likelihood of out-of-town travel for treatments and procedures currently available at our facilities.”

Unity Healthcare leaders will continue to meet with Anthem in hopes that an agreement can be reached. In the interim, Unity is encouraging patients with Anthem coverage to learn more about the issues at unityhc.com/anthem and familiarize themselves with alternate insurance providers including Cigna, Humana and UnitedHealthcare.

About Unity Healthcare:
Unity Healthcare is a medical network with over 75 general and specialty physicians serving Lafayette, Indiana and surrounding communities. Unity provides care for more than 200,000 patients per year and employs over 575 healthcare professionals. Unity Healthcare physicians provide an array of medical services with specialists in allergy and asthma, anesthesiology, gastroenterology, general and trauma surgery, immediate care, obstetrics and gynecology, occupational medicine, ophthalmology, oncology, orthopaedics, orthopedic spinal surgery, otolaryngology, neurology, pain management, pediatrics, phlebology, physical and occupational therapy, plastic surgery, podiatry, primary care, psychology, radiology, radiation oncology, urology, and many others.

LAFAYETTE, Ind. -– Based on a ruling yesterday (March 30) from the Marion County Superior Court-Civil Division in Indianapolis, Anthem Blue Cross and Blue Shield will continue to recognize facilities operated by the Sisters of St. Francis Health Services (SSFHS), including St. Elizabeth Medical Center and Home Hospital, as in-network until the contracts between Anthem and SSFHS expire Sept. 1, 2009.

Although Anthem had sought to terminate the contracts early, the court ruling means that members of Anthem health plans can continue to receive in-network services at SSFHS facilities after May 1. The hospitals include St. Francis Hospital & Health Centers in Beech Grove, Indianapolis and Mooresville; St. Elizabeth Medical Center and Home Hospital in Lafayette; St. Clare Medical Center in Crawfordsville; St. Anthony Memorial Health Centers in Michigan City; St. Anthony Medical Center in Crown Point; St. Margaret Mercy Healthcare Center in Hammond and Dyer; and Franciscan Physicians Hospital in Munster.

The current Anthem-SSFHS contracts expire Sept. 1, 2009 with the exception of St. Elizabeth Regional Health’s contract which will continue at least through Dec. 31, 2009.

But leaders from both organizations emphasized they are committed to continuing contracts talks and securing a new long-term agreement to ensure that Anthem-insured patients receive in-network benefits at the highest level of care at all SSFHS hospitals.