Bayhealth, Highmark reach agreement

DOVER — With the clock ticking, Highmark Delaware insurance and Bayhealth Medical Center announced early Friday evening they have reached an agreement in principle that Bayhealth will remain an in-network option for Highmark Delaware members.

The agreement in principle is binding and will be implemented through formal agreements to be completed by May 20, Bayhealth Marketing Operations Manager Amanda Bowie said in a statement.

“Bayhealth remains committed to investing in and providing quality care for the residents of central and southern Delaware,” said Terry Murphy, president and CEO of Bayhealth, in a statement. “We are extremely pleased that we were able to reach an agreement with Highmark Delaware that allows us to uphold that commitment.”

Tim Constantine, president of Highmark Delaware. also praised the agreement.

“Highmark Delaware’s new contract with Bayhealth achieves the important balance of fairly reimbursing a community-based health system to provide high quality care to our members, while also recognizing the need to maintain comprehensive and affordable health benefit programs for our members and customers,” he said in the joint statement issued at 5:04 p.m. Friday.

The joint statement did not give details on how the two sides resolved their differences.

The agreement removes the possibility that some 19,000 Highmark Blue Cross Blue Shield patients in central and southern Delaware treated in the Bayhealth system would find themselves paying more out-of-pocket costs after the Sunday deadline.

The two entities have worked together since 1982 but Highmark notified Bayhealth in January of its intention to terminate the current contract on May 15; the contract had been in place since 2000.

At the termination of the contract, Bayhealth would have become an out-of-network health care provider for those with Highmark insurance.

Both Bayhealth and Highmark representatives were mum on the status of negotiations when contacted earlier Friday.

In an April 13 letter to its members, Highmark stated: “Bayhealth’s current rates are unsustainable and will result in higher premiums and costs for our members.”

Bayhealth gave its side in an April 18 letter to its patients: “Highmark has asked for significant reductions in payment that we simply cannot accept. These significant cuts will not allows us to continue to provide the quality care that our patients and Highmark subscribers expect and deserve from us.”

Meanwhile, on Thursday, a group of lawmakers asked the Office of Management and Budget to extend the open enrollment period currently underway for state of Delaware employees to switch their health care plans since Highmark is one of their options.

OMB spokesman Bert Scoglietti said in an email the office currently had no plans to do so.

Bayhealth said in an April 24 Delaware State News article that the rising cost of health care services it provides can be attributed to capital improvements, rapid community growth forcing Bayhealth to expand capacity, higher pharmaceutical costs, costs associated with attracting and retaining high quality physicians, cancer treatment costs, electronic health record implementation among others.

Over the past 12 months, 19,000 Highmark members have utilized Bayhealth’s services at Dover’s Kent General Hospital and at Milford Memorial Hospital.

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