Tag: BlackBook
Investor Use Case: Beat the HHS Vertical Learning Curve
Health Plan Use Case: Save Time Vetting Vendor Sales Pitch Meetings
Solution Vendor Use Case: Know Your Competition
How to access the different types of content
How to login
Health Alliance Plan Acquisition Of Trusted HP – Michigan Approved
MM 1 Sentence Summary- Health Alliance acquires Trusted HP-Michigan
Health Alliance Plan Acquisition Of Trusted HP – Michigan Approved (highlighted)
Transaction begins Medicaid expansion in metro Detroit for HAP and Henry Ford Health System
News provided by
Sep 19, 2019, 11:15 ET
Henry Ford Health System and Health Alliance Plan (HAP), a nonprofit health plan and operating unit of , announced today that HAP’s acquisition of Trusted HP – Michigan has received all regulatory approvals and the acquisition became effective on .
Wright Lassiter III, president and CEO, Henry Ford Health System
Dr. Michael Genord, Interim President & CEO, HAP
(PRNewsfoto/Health Alliance Plan,Henry Ford)
Henry Ford and HAP announced in June that HAP had signed a definitive agreement to acquire Trusted HP – Michigan, a Medicaid plan based in Detroit, formerly known as Harbor Health Plan, Inc. The completion of this transaction solidifies HAP’s re-entrance into the state of Michigan’s Medicaid HMO service area known as Region 10, which includes Wayne, Oakland and Macomb counties.
“Participation in Michigan’s Region 10 Medicaid service area is a key strategic priority for Henry Ford and HAP given our geographical footprint, and this acquisition positions us for Medicaid growth in our primary service area,” said Wright Lassiter III, President and CEO, Henry Ford Health System. “HAP and Henry Ford are dedicated to using our joint assets and unique integrated health system programs to improve the quality and access to care for this area’s Medicaid patients, which are among our most vulnerable populations.”
HAP acquired Trusted HP – Michigan from Trusted Health Plan Inc., a Washington, D.C.-based managed care organization. Previously named Harbor Health Plan and ProCare Health Plan, the plan has been operating as a licensed HMO in Michigan since 2000. As a result of this transaction, Trusted HP – Michigan’s nearly two dozen employees will become HAP employees.
The terms of the agreement provide for a seamless transition for Trusted HP – Michigan members, who will be able to keep their doctor and continue using their services and current ID cards. There is no impact to current HAP members as a result of this transaction. The Trusted brand will remain in place through the end of 2019. Effective January 1, 2020, all Medicaid members will be under one HAP-branded Medicaid name.
“HAP and Henry Ford Health System are focused on providing Medicaid beneficiaries with a differentiated care model focused on value-based care,” said Dr. Michael Genord, interim president and CEO, HAP. “We are investing in care coordination programs, including those aimed at social determinants of health, to improve the health and well-being of the members we serve. And we are thrilled that this now includes Trusted’s Medicaid members, most of whom are in Wayne County.”
HAP serves 570,000 total members across Michigan. HAP’s subsidiary, HAP Midwest Health Plan, offers Medicaid products under the HAP Empowered name. HAP Empowered is currently available in Region 6, which includes Genesee, Huron, Lapeer, Sanilac, Shiawassee, St. Clair and Tuscola counties. Covered Medicaid programs offered through HAP Empowered include health care coverage for people impacted by the Flint water crisis, MIChild, Healthy Michigan Plan and Children’s Special Health Care Services.
HAP also participates in the MI Health Link Dual Demonstration Project, serving 4,500 members who are eligible for both Medicare and Medicaid in Wayne and Macomb counties, including some of the most underserved areas of Detroit.
About Henry Ford Health System
Henry Ford Health System is a six-hospital system headquartered in Detroit, Michigan. It is one of the nation’s leading comprehensive, integrated health systems, recognized for clinical excellence and innovation. Henry Ford provides both health insurance and health care delivery, including acute, specialty, primary and preventive care services backed by excellence in research and education. Henry Ford Health System is led by President & CEO Wright Lassiter III. Visit HenryFord.com to learn more.
About Health Alliance Plan
Health Alliance Plan (HAP) is a Michigan-based, nonprofit health plan that provides health coverage to individuals and companies of all sizes. For nearly 60 years, HAP has partnered with leading doctors and hospitals, employers and community organizations to enhance the health and well-being of the lives it touches. HAP offers a product portfolio with six distinct product lines: Group Insured Commercial, Individual, Medicare, Medicaid (using the HAP Empowered name), Self-Funded and Network Leasing. HAP excels in delivering award-winning preventive services, disease management and wellness programs, as well as personalized customer service. For more information, visit www.hap.org.
SOURCE Henry Ford Health System; Health Alliance Plan
Related Links
New Hampshire regulators block Partners acquisition over antitrust concerns – Boston Business Journal
MM 1 Sentence Summary- NH attorney general blocks Massachusetts Gen Hospital from acquiring Partners saying it will violate state antitrust laws
New Hampshire regulators block Partners acquisition over antitrust concerns
Sep 20, 2019, 1:07pm EDT
Partners HealthCare’s plan to further its expansion into New Hampshire ran into a roadblock on Friday, with the Granite State’s attorney general, Gordon MacDonald, saying the acquisition would violate state antitrust laws.
In May 2018, Partners’ flagship Massachusetts General Hospital announced that it planned to acquire Exeter Health Resources in New Hampshire. Plans called for Exeter to merge with Wentworth-Douglass Hospital, which MGH acquired in 2017, forming a new non-profit system for New Hampshire’s Seacoast region.
While the attorney general’s charitable trusts unit has been reviewing the transaction since the hospitals submitted materials in May 2019, the attorney general’s consumer protection and antitrust bureau has been conducting a private review of the transactions for over a year.
Last week, the antitrust division issued a notice of intent to halt the transaction over concerns of antitrust violations. The charitable trusts unit subsequently issued a report Friday objecting to the proposed transaction, noting that if the hospitals resolve concerns with the antitrust division, it can refile its submission to charitable trusts.
“Our most important duty is to protect the public and we will not hesitate to use the enforcement tools available to us to do so,” MacDonald said in a statement. “New Hampshire patients already pay some of the highest prices for health care in the country. Based on our investigation, we have concluded that this transaction implicates our laws protecting free and fair competition and therefore threatens even higher health care costs to be borne by New Hampshire consumers.”
In a release, hospital officials said they expect to continue conversations with the attorney general on the benefits of the transaction to ultimately resolve the concerns.
“We are optimistic that the parties can continue to have an open dialogue with the regulators or government officials about this important affiliation,” said Dr. Peter Slavin, MGH’s president. “We remain fully committed to seeing this transaction through and are confident that the Attorney General’s Office will ultimately determine that our affiliation will pass antitrust review based on the thorough review that the expert economists have completed on this proposal. We look forward to continuing to enhance quality healthcare in the Seacoast Region.”
Blue Cross puts merger on hold amid video showing CEO sideswiping tractor trailer on I-85
MM 1 Sentence Summary- BCBS and Cambia Health’s merge has been delayed because of CEO Conway’s legal trouble
Blue Cross puts merger on hold amid video showing CEO sideswiping tractor trailer on I-85
September 24, 2019 12:57 PM
Video appears to show BCBS CEO driving erratically, hitting tractor-trailer on I-85
A video provided to The News & Observer appears to show an SUV driven by Patrick Conway, president and CEO of Blue Cross and Blue Shield of NC, weaving between lanes for several miles on Interstate 85 before colliding with a tractor-trailer. By Submitted Video
ASHEBORO
North Carolina’s largest health insurer on Tuesday suspended an ongoing merger, making the announcement the same day new details emerged about its CEO’s recent driving charges.
“Blue Cross NC has decided to put its proposed strategic affiliation with Cambia Health Solutions on temporary hold,” the company announced in an email to media shortly after 3 p.m. “Blue Cross NC is committed to focusing on its customers, employees and the North Carolina communities it serves.”
TOP ARTICLES
Blue Cross and Blue Shield of North Carolina and Cambia, an Oregon-based company, announced their intentions to form a partnership in March. The two companies would together cover around 6 million people and have about $16 billion in combined revenue, the News & Observer previously reported.
Blue Cross is bigger than Cambia, reporting $9.9 billion in revenue last year and covering 3.7 million people. Cambia had revenue of about $6 billion on coverage of around 2.6 million people.
Blue Cross announced the merger being put on hold on the same day that new details emerged about Dr. Patrick Conway, its president and CEO. A video provided to The News & Observer Tuesday appears to show Conway weaving between lanes for several miles on Interstate 85 before sideswiping a tractor-trailer.
Conway, 45, was charged with driving while impaired and misdemeanor child abuse after the June 22 accident. His two daughters were in the car, according to police.
Video of Conway’s car
The video, shot by a motorist on I-85 and sent to police, shows an SUV that appears to match the 2017 Cadillac listed on the report from Archdale police.
An affidavit from the Archdale officer said Conway smelled of alcohol, had bloodshot eyes and slurred speech and was unsteady on his feet. He refused a blood-alcohol test and had his license revoked for 30 days, according to court records.
According to a confidential police report obtained by WRAL, Conway denied wrongdoing and later became “belligerent” at the police station.
The report quotes Conway saying: “’You had a choice. You could have let me go. You don’t know who I am. I am a doctor, a CO of a company. I’ll call Governor Cooper and get you in trouble,’“ WRAL reported.
Cooper “was not involved in this incident in any way,” spokesman Ford Porter told The N&O.
Blue Cross didn’t comment on Tuesday’s reports. Conway’s attorney, Thomas Walker, released a statement to the N&O saying the CEO is “deeply ashamed and embarrassed” about the pain he caused family and co-workers.
“He knows his conduct was unacceptable and not consistent with who he is as a person. He has never had an incident like this before,” Walker said.
“To his credit, he immediately disclosed the incident to the Blue Cross NC Board. He stepped down from his daily duties and voluntarily and successfully completed 30 days of inpatient substance use treatment. He’s committed to continuing to handle this appropriately going forward and will do so.”
Blue Cross response
Last week, state Insurance Commissioner Mike Causey asked for Conway to be replaced by an interim president while his charges are resolved, calling them “alarming.”
He also chided the Blue Cross board for appearing to hide the arrest, saying he expected the insurer’s executive team to be more “accountable, responsible and transparent.”
Conway earned $3.59 million last year, WRAL reported.
In response, board Chairman Frank Holding Jr. said Conway had undergone a professional substance abuse assessment and attended a 30-day inpatient treatment.
“Based on detailed information shared by the facility based on Dr. Conway’s assessment and treatment, the board was satisfied Dr. Conway could continue to provide strong leadership to BlueCross NC,” Holding’s letter said.
Blue Cross “refrained” from talking publicly about Conway’s incident “out of respect for the legal process underway in Randolph County, Dr. Conway’s right to due process, and medical privacy concerns and obligations,” Holding added.
Washington commissioner’s letter
On Tuesday night, Washington’s state insurance commissioner released a letter he sent to Cambia Heath Solutions’ Board of Directors earlier that day.
In the letter, Commissioner Mike Kreidler said his office is reviewing the proposed merger of Cambia with Blue Cross. Cambia was formerly known as The Regence Group, according to its website.
Krieidler said he learned only about Conway’s June arrest on Sept. 19, the day news reports were published about the allegations. He said he learned about the arrest after Cambia CEO Mark Ganz asked for his personal cell phone number “to communicate an urgent message that could not wait until normal business hours.”
Kreidler said Blue Cross should have notified him immediately and had a “legal obligation” to inform him within two business days of “any material changes” to Conway’s biographical affidavit.
“The fact that Dr. Conway was arrested and faces serious allegations and charges is without question a material change,” Kreidler wrote.
“I am deeply troubled by your failure to communicate responsibly and transparently,” he said in the letter to the board of directors. “Both the board and CEO share the responsibility to deal with my office in a straightforward and honest fashion. Secrets are not permissible.
“Your behavior in this matter must, and will, be taken into account as my office considers the Cambia/Regence’s request for a merger,” the letter concluded.
Staff writers Zachery Eanes and Mark Schultz contributed to this story
Paul “Andy” Specht reports on North Carolina leaders and state politics for The News & Observer and PolitiFact. Specht previously covered Raleigh City Hall and town governments around the Triangle. He’s a Raleigh native who graduated from Campbell University in Buies Creek, N.C. Contact him at as*****@**********er.com or (919) 829-4870.
Major Blue Health Insurers Drop Deal to Combine
Move comes after resignation of North Carolina insurer CEO Patrick Conway
By
Anna Wilde Mathews,
Leslie Scism and
Valerie Bauerlein
Oct. 11, 2019 8:51 pm ET
Blue Cross and Blue Shield of North Carolina and Cambia Health Solutions said they were dropping plans to combine, after the resignation of the North Carolina insurer’s chief executive.
Former Blue Cross of North Carolina CEO Patrick Conway had stepped down amid fallout over an allegedly alcohol-related traffic accident. The two insurers had said they were pausing their deal on Sept. 24, as details of the June incident emerged.
Optima Health to take majority stake in Virginia Premier | Virginia Business
MM 1 Sentence Summary- Optima Health Plan takes majority ownership of MCO VA Premier and together they will serve 800k members.
Optima Health to take majority stake in Virginia Premier (Highlighted)
Virginia Beach-based Optima Health Plan will become the majority owner of Richmond-based Virginia Premier, a nonprofit managed-care organization.
Virginia Premier was founded in 1995 by VCU Health System. The Richmond-based health system will retain a 20% ownership stake in Virginia Premier. Together, Optima and Virginia Premier will serve nearly 800,000 members. Optima is a subsidiary of Norfolk-based Sentara Healthcare.
“As provider-led health plans, Optima Health and Virginia Premier share similar cultures, values and a commitment to delivering innovative services that meet the unique needs of the populations we serve,” Dennis A. Matheis, president of Optima Health and executive vice president of Sentara Healthcare, said in a statement. “Together, we will be better positioned to increase access to quality care, achieve greater efficiencies and develop new services to improve our members’ overall experience.”
Optima and Virginia Premier are two of the state’s original Medicaid managed care organizations. Company officials said Virginia Premier and Optima will continue to operate as separate entities, retaining their names and brands. Virginia Premier will maintain an operations center in Richmond and a presence in other areas in the state.
Measure
Measure