Business & Tech

Beaumont, Blue Cross Agree on Contract

Patients such as Rachel Hunt breathe sigh of relief they won't lose their Beaumont doctors as the health care insurer and hospital system reach a five-year agreement.

Blue Cross Blue Shield of Michigan (BCBSM), Blue Care Network and signed a five-year agreement Friday that keeps Beaumont in the Blue Care Network.

“This is happy news,” said Nickolas Vitale, Beaumont's executive vice president and chief financial officer. “We have been working on this for a number of months.”

Vitale said the hospital and Blue Cross finally reached consensus on key issues and were able to hammer out an agreement.

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Susans Barkell, BCBSM senior vice president, said the new contract moves away from the traditional fee-for-service payment approach and focuses on an outcomes-based approach. This means, for example, that payment will be made based on overall performance and treatment of the patient for a particular diagnosis, rather than on the specific procedures or tests conducted in that treatment.

The settlement brought relief to the 200,000 BCBSM patients who received a letter from the health care provider in October saying the contract with Beaumont would expire on Dec. 31, 2011. Those patients represent just less than 5 percent of Beaumont's 4.3 million customers.

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"If we didn't reach this agreement, we would not have been able to take people from the Blue Care Network beginning on Jan. 12," Vitale said.

Rachel Hunt of Lake Orion is one of the people who would have been affected. “I read the letter again and again,” Hunt said. “I was so nervous.”

Hunt was diagnosed with breast cancer in May 2009. She has had a double mastectomy, reconstruction, an oophorectomy (removal of ovaries) and genetic counseling through Royal Oak Beaumont. Dr. Laura Nadeau is her Beaumont oncologist.

Hunt, who is now cancer free, goes for follow-up testing every six months.

“I couldn’t imagine going to anyone but Dr. Nadeau,” Hunt said. “To ask me to find another doctor would be like asking me to find a new friend. There are some things that can never be replaced."

Hunt, who gave birth to two of her three children at Beaumont, said she was ecstatic when she heard today's news.

The Blues' Barkell said BCBSM will provide funding to Beaumont to build an infrastructure to better integrate care services between the health system and physician groups.

“Patients coming to Beaumont can feel comfortable that their care is going to be coordinated,” Barkell said. Patients admitted to Beaumont will be part of a registry that will alert doctors of certain health conditions, such as diabetes, ensuring efficient use of tests and procedures.

“It’s very innovative, and we are very excited about it,” Barkell said.


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