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Sisters of St. Francis Health Services, Anthem contract ensures continuum of care for patients

admin — Thu, 03 Sep 2009 06:00:29 +0000

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.

“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.”

St. Elizabeth Regional Health remains in Anthem network; negotiations continue

admin — Wed, 01 Apr 2009 02:40:45 +0000

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.

St. Elizabeth Regional Health opts out of Anthem network November 2

admin — Thu, 16 Oct 2008 20:39:59 +0000

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.

Sisters of St. Francis Health Services announce new vice president for Innovation

admin — Thu, 16 Oct 2008 20:26:05 +0000

MISHAWAKA, IND. — The Sisters of St. Francis Health Services (SSFHS) is pleased to announce that James C. Sparks, Ph.D. has been appointed vice president for Innovation for SSFHS.

James C. Sparks

Dr. Sparks received his bachelor’s of science and doctorate degrees in biology and biochemistry from the University of Tennessee at Knoxville, and he received his post-doctoral training in clinical laboratory science at the University of Tennessee Memorial Research Center and Hospital in Knoxville. Dr. Sparks is an associate fellow of the National Academy of Clinical Biochemistry and has more than 35 years experience in health care operations, primarily in the clinical laboratory arena.

In his new role, Dr. Sparks will work with SSFHS’ senior leadership and with system and hospital medical, quality and performance improvement leaders to identify and share operational and clinical best practice standards and processes throughout the system. He will also facilitate a system-wide approach to new and emerging health care technology identification and evaluation using existing technology assessment teams and processes to develop transparent and consistent approaches and strategies in this key capital investment arena.

Dr. Sparks previously served SSFHS as the president and CEO of their seminal central laboratory venture and was instrumental in leading the merger of its operations with the laboratory operations of two other health care systems in the Chicago area – Provena Health and Resurrection Health Care. Prior to his service at SSFHS, Dr. Sparks was a member of senior leadership at Specialty Laboratories, Genzyme Genetics, Nichols Institute and SmithKline Beecham Clinical Laboratories. He also served as an independent consultant to pathology practices and to biotechnology entrepreneurs and investors.

“Purposeful, worthwhile work and the opportunity to make a difference in the lives of others have all been part of my experience over the years I have been part of SSFHS. Our mission of continuing Christ’s ministry in our Franciscan tradition is the best descriptor of a healing mission as I can imagine, and we who work in this ministry are blessed to be able to participate in this mission. All of our employees are part of our system to do well by doing good, and we are continuing to find ways to bring our collective attention to patient-centered care that is safe, effective, efficient, timely and equitable. It is a deep honor and privilege for me to be a part of this community of servant-leaders and to make whatever contribution I can to further its mission and values.”

Dr. Sparks and his wife have lived in downtown Chicago for the past 10 years and are active in neighborhood and charitable organizations and functions.

St. Elizabeth Regional Health, Humana reach contract for in-network health benefits

admin — Wed, 17 Sep 2008 19:23:58 +0000

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.

Lafayette Online » SSFHS

Sisters of St. Francis Health Services, Anthem contract ensures continuum of care for patients

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