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. -– The Sisters of St. Francis Health Services Inc. (SSFHS) announced October 13 that its contract with Anthem Blue Cross and Blue Shield of Indiana is set to end November 2, 2008.

Reasons for the termination include Anthem’s lack of accurate and timely claims payment and the inability to secure contract terms comparable to other hospitals in the area, SSFHS officials said.

The termination will cover the following SSFHS hospitals and physicians:

• St. Elizabeth Regional Health, including St. Elizabeth Medical Center and Home Hospital in Lafayette;
• St. Clare Medical Center in Crawfordsville;
• St. Francis Hospital & Health Center in Indianapolis;
• St. Francis Hospital & Health Center in Beech Grove;
• St. Francis Hospital & Health Center 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; and
• More than 300 physicians in the different SSFHS service areas.

“SSFHS is a good partner that works closely with payers to resolve claims problems when they occur,” said Greg Yust, SSFHS vice president of managed care contracting. “We recently forged successful long-term agreements with Aetna, Humana, Sagamore and CIGNA. The Anthem claims issues have been ongoing for more than a year with no progress whatsoever.”

St. Elizabeth hopes to work out a new agreement with Anthem. In the event SSFHS is unable to reach an agreement, it will continue to work with Anthem, patients and employers to limit the impact the contract dispute might cause.

LAFAYETTE, Ind. — Humana and St. Elizabeth Regional Health have reached a new contract that will provide in-network health care benefits for 164,000 Humana of Indiana members at Sisters of St. Francis Health Services facilities beginning October 2008.

St. Elizabeth Regional Health had been out of Humana’s network since June 2007. The new contract affects all Humana groups; individual and Medicare plan members.

“This agreement enables us to provide the same top-quality care to Humana members that we do to all those we currently serve at our hospitals and practice groups,” said Kevin Leahy, SSFHS president and chief executive officer.

“The addition of St. Elizabeth Regional Health to our hospital network brings to our members one of the country’s premier health systems,” said Humana of Indiana President Veronica Martin. “This agreement reinforces Humana’s commitment to health care provider choice for our members and the collaborative approach both organizations embraced as we worked toward an agreement should be a model for provider/payer relationships.”

The following facilities will join the Humana network:

• St. Elizabeth Medical Center (Lafayette)
• Home Hospital (Lafayette)
• St. Clare Medical Center (Crawfordsville)
• St. Francis Hospital & Health Center (Indianapolis)
• St. Francis Hospital & Health Center (Beech Grove)
• St. Francis Hospital & Health Center (Mooresville)

Humana members with questions should contact Humana’s Customer Service Center at the toll free number on their member ID cards. A full listing of Humana network participating hospitals is also available at www.humana.com.

About St. Elizabeth Regional Health

St. Elizabeth Regional Health includes St. Elizabeth Medical Center and Home Hospital in Lafayette, Sigma Medical Group, Woman’s Clinic and Lafayette OB/GYN. St. Elizabeth Regional Health and is part of a network of 13 hospital campuses in Indiana and Illinois owned and operated by the Sisters of St. Francis Health Services Inc., one of the largest health care systems in Indiana. St. Elizabeth Regional Health, combined with St. Clare Medical Center in Crawfordsville, form the Western Indiana Region of the Sisters of St. Francis Health Services. For more information, go to www.ste.org.