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DEAL KEEPS MOUNT ST. MARY'S IN THE BLUES NETWORK

Under an agreement reached Wednesday, Mount St. Mary's Hospital and Health Center will continue to accept Blue Cross Blue Shield subscribers after Jan. 1.

In July, the hospital had announced that, except in emergencies, it would not accept Blue Cross Blue Shield patients after the end of the year unless the health insurer increased its payments.

The new three-year agreement provides for "increased reimbursement to Mount St. Mary's in recognition of its continued commitment to comprehensive quality initiatives," according to Wednesday's joint statement.

Under the agreement, St. Mary's will continue to accept Blue Cross Blue Shield members enrolled in the Community Blue, Traditional Blue, Medicare Choice and the Traditional Blue Medicare Preferred Provider Organization plans on an in-network basis.

In addition, St. Mary's will participate in Senior Blue, beginning Dec. 1.

In their statement, Stephen G. Jepson, senior vice president of Blue Cross Blue Shield, and Angelo G. Calbone, president of St. Mary's, said:

"This is good news for our members and patients who count on maintaining their health care provider relationships. We're pleased to continue to strengthen our collaborative relationship with the goal of providing affordable quality care for our members and patients."

Calbone contended that St. Mary's was driven to such a "harsh position (because) we weren't meeting our costs."

In July, he said Blue Cross Blue Shield was charging its subscribers higher rates than other insurers, such as Independent Health and Univera Healthcare, yet it was paying Mount St. Mary's less than what the other health plans pay for similar services. He said the hospital already has cut costs, including reducing the number of employees.

"We only want our fair share so Mount St. Mary's Hospital can continue to provide quality care and a stable organization for our community and employees," Calbone said.

Officials at Blue Cross Blue Shield, a division of HealthNow New York, countered that they had offered the hospital new rates, including incentives for quality improvements, that were comparable to the rates the health plan pays other hospitals in the region.

"While we want to ensure that our participating hospitals are being reimbursed adequately, we know that if we give Mount St. Mary's the increase they are requesting, we will have to pass those costs on to our employers and members in the form of higher premiums," Jepson said in July.

e-mail: jscelsa@buffnews.com

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