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Jul 21, 2009 6:19 PMPublication: The East Hampton Press

Hospital talks at impasse; Bishop threatens to call for investigation

Jul 21, 2009 6:19 PM

“I thought it was completely disingenuous, what he did today,” financial planner Kevin Luss of The Luss Group in Southampton said Monday. “He politicized a situation which is really quite serious out here.”

Mr. Luss, who also writes a financial column for The Southampton Press, attended the press conference and said he brokers health plans for hundreds of clients who use Empire.

“I thought the hospital did itself a disservice by trashing Empire, then saying, ‘I hope now they can come to the table and negotiate in good faith,’” he said.

Mr. Connor, who is also the president and CEO of Eastern Long Island Hospital in Greenport, said that the gap between what Empire is paying now and the market rate is evidence that the insurance company has been underpaying the hospitals for years. “Shame on them for having to give us this big increase to have to get to market rate,” he said.

East End employers are paying Empire the same premiums as western Suffolk County employers do, while the East End hospitals are being reimbursed a far lower rate, Mr. Connor said. And while WellPoint had a profit of $2.5 billion in 2007, the Alliance hospitals collectively lost $12 million, he said.

“If the hospitals are losing money, it’s probably due to some other operational problem or inability to attract patients and manage their own capacity and has nothing to do with private commercial rates,” Mr. Andrews said.

The spokesman said that the hospitals are not making a serious attempt to achieve the improvements and cost savings that the Berger Commission suggested the three institutions could reach by merging. The Berger Commission was a bipartisan New York State panel that studied health care delivery in the state and offered recommendations in 2006.

“This kind of increase is unacceptable to every Empire member, their family, employers and unions that pay for coverage,” Mr. Andrews said. “This is particularly true given the fact that Empire already reimburses these hospitals at amounts comparable to Empire’s reimbursement to like facilities on Long Island and the New York City metro area.”

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There simply isn't an acceptable argument why Empire should not re-imburse at the same rates in Southampton, Riverhead and Greenport as they would in Brookhaven and Mather . For too many years the East End Health providers/institutions have operated at a loss relative to their up island counterparts because collectively profitable insurance compaines have practised in this way.
By lo-cal (78), southampton on Jul 22, 09 1:45 PM
I have been in the healthcare field for over 30 years, a biller for 15 years and in fairness to all THREE sides of this problem, Why is there an issue to the reimbursement rates of Empire Blue Cross/Wellpoint? This could be due to a number of causes. The first one being the payment rates are to low for hospital reimbursement in comparison to other hospitals within a certain radius. In my previous experience in dealing with Empire Blue Cross, it was stated to me by an Empire Blue Representative, ...more
By medbiller (1), riverhead on Jul 23, 09 12:10 PM
Ok so Bishop is trying to help out with this situation. He should also be listening to the people and be receptive to requests by constituents. We don’t need just another rubber stamp for Obama. These people are angry, (not whacko’s). As of now we have not seen any improvement in the economy the unemployment rate is almost at 10%. The stimulus that Mr. Bishop voted yes for has done nothing. I say no to the health care proposal and no to end of live decisions. No one should have to make a decision ...more
By golfbuddy (180), hampton bays on Jul 28, 09 8:22 AM
Way to politicize the healthcare of millions of people, golf. Besides that egregious action, you do not have the facts on your side. The economy has significantly improved since the President took office when he inherited the worst financial mess imaginable created entirely by the Bsh administration. Obama's stimulus package has prevented millions of families from becoming destitute and Bishop spends a good deal of his time doing nothing BUT going around listening to his constituents.
By ATG (2), Water Mill on Jul 22, 10 12:45 AM