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Hamlin elected to NY fed

Area hospitals and insurers are pushing the midnight deadline for setting rates for 1997.
It is clear, however, that the final rates will be lower than the state-mandated rates set under the New York Prospective Hospital Reimbursement Methodology, which expires tonight.
Most area hospitals have handshake agreements with Finger Lakes Blue Cross and Blue Shield, and are trying to agree on final details with Preferred Care today, officials said. The hospitals have focused on reaching agreements with the two market leaders, and many insurers with fewer customers in Rochester will reach deals in the next few months.
The same pace is true for the rest of the state, said Richard Dobell, president of the New York State Association of Professional Benefit Administrators Inc. and a member of the state Health Department’s task force on the transition to negotiated rates.
Rochester, though, so far has not had the problems that some areas have had with hospitals refusing to sign agreements, saying the deals would not cover costs.
The local hospital systems have not disclosed the new rates, and with the increasingly competitive environment are not expected to in the future.
But Leo Brideau–CEO of the University of Rochester hospital system, which includes Strong Memorial Hospital and Highland Health System Inc.–said the rates for Blue Cross are “fair and reasonable, reducing the overall costs but at levels we are willing to accept.”
Statewide, the contracts are producing rates averaging some 10 percent less than those set by the state, Dobell said.
Pushed by the local business community, area insurers and hospitals have been trying to cut overall health care costs by 10 percent to 20 percent.
The local community also is following a statewide trend of pulling state charges for bad debt and charity care, and graduate medical education, out of the rate negotiations. That means employers and insurers will pay those costs, instead of the hospitals.
A proposal to set up a Graduate Medical Education Consortium so the local community–instead of the state–can decide where the GME charges are spent is in limbo, Brideau said. The final proposal was sent to the state Health Department, but local officials do not expect a final decision until other problems with the NYPHRM sunset are ironed out.
Stephen Hooper, president of Health Economics Group, a third-party administrator, said the negotiations process, as well as figuring out how the charges will be administered, has been “chaotic.”
The self-insured Wayne-Finger Lakes Medical Plan contracted with the New York City-based Group Health Insurance Inc. for hospital coverage in anticipation of the change, Hooper said. Other self-insurance plans are joining networks that are negotiating rates.

Hamlin elected to NY fed

Area hospitals and insurers are pushing the midnight deadline for setting rates for 1997.
It is clear, however, that the final rates will be lower than the state-mandated rates set under the New York Prospective Hospital Reimbursement Methodology, which expires tonight.
Most area hospitals have handshake agreements with Finger Lakes Blue Cross and Blue Shield, and are trying to agree on final details with Preferred Care today, officials said.

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