Sharp HealthCare Ends Contract with Some Prudential Plans
Sharp HealthCare hospital system has terminated its contract with Prudential's managed care plans, citing low reimbursements and too few patients, the San Diego Union-Tribune reports. The contract will end on April 1, and about 3,500 Prudential HMO and point-of-service members in San Diego County could lose access to five Sharp hospitals and one skilled-nursing facility. However, patients with procedures already scheduled and pregnant women in their second or third trimesters will be able to continue their course of care. Ann Pumpian, Sharp's chief financial officer, said the contract termination was "triggered" by the move of Prudential members to Aetna after the two insurers merged in 1999. Last year, more than 22,000 Prudential members had access to Sharp, but with only 3,500 members still eligible for service after the merger's implementation, Pumpian said the hospital needed higher reimbursements "to make doing business viable." Aetna spokesperson Rachelle Cunningham said, "We're so far apart on where we wanted to be that there's no hope we can reach an agreement." Prudential members who were planning to switch to Aetna plans by the end of the year may do so by May 1 to continue receiving care from Sharp hospitals (Fong, San Diego Union-Tribune, 3/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.