BAYCARE: IPA Loses HealthNet, Blue Shield Contracts
HealthNet and Blue Shield of California have terminated their contracts with BayCare Medical Group, citing concerns over the IPA's "bill-processing and cash-flow problems," the San Francisco Chronicle reports. BayCare Chair Dr. Tom Yatteau said his group "is working to catch up with an accounts-receivable backlog of 45 to 90 days," and that "last week, a private investor pumped $1 million" into the IPA and pledged an additional $2 million to $3 million "to cover any cash flow crunch." Citing a similar feud between Aetna U.S. Healthcare and San Mateo IPA, the Chronicle notes that these types of HMO-IPA disputes "are occurring more frequently as IPAs are taking on more financial risk at a time when cost-cutting throughout the medical system is squeezing profits."
Things that Make You Go Hmmm
Noting that PacifiCare is keeping its contract with BayCare, Yatteau said the timing of HealthNet's termination was "suspect" as BayCare recently secured a "substantial increase" in its monthly per-patient fees from HealthNet. HealthNet would not comment on this insinuation, but did confirm that the contract termination is effective Feb. 28. Blue Shield spokesperson Clark Miller said his HMO's contract with BayCare will be discontinued effective early March. The Chronicle reports that most of HealthNet and Blue Shield members "won't notice the change" because most doctors have more than one IPA affiliation, but that those enrollees who "visit doctors who have no other IPA affiliation" will have to choose a new doctor and health plan (Abate, 2/11). Click BayCare for previous coverage of the IPA.