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Jan 27, 2010 11:07 AMPublication: The Southampton Press

Long-awaited contract between Empire and Health Alliance may be near

Jan 27, 2010 11:07 AM

After nearly six months without a contract, the East End Health Alliance and Empire BlueCross BlueShield are talking compromise, according to Alliance spokesman Paul J. Connor, and negotiations have taken a positive, “productive” turn.

While Mr. Connor stopped short of suggesting that a deal is imminent—“I can’t predict if and when we will agree on this contract,” he said this week—he admitted that “in the past five months, we haven’t seen this type of movement. Both sides are talking about compromising.”

Empire and the Alliance, which comprises Southampton Hospital, Peconic Bay Medical Center in Riverhead and Eastern Long Island Hospital in Greenport, have been at loggerheads for months over reimbursement rates Empire pays to the hospitals for treating its patients.

Although specific details about the negotiations have been kept private, State Senator Kenneth P. LaValle, who has been closely involved in the proceedings, said this week that a long-awaited deal is closer than at any other point during negotiations, which have stretched over most of the past year. He said he is confident that both sides will be pleased as their negotiations draw to a conclusion.

“In any negotiations, people must realize that there has to be a conclusion, and I think both sides are very close—whether it’s the end of this week, or next week, or the week after that,” Mr. LaValle said on Tuesday. “A lot of people worked very hard to get an agreement that works and to ensure that we can continue to have quality health care on the East End.”

Sally Kweskin, director of corporate communications for Empire, the largest private insurer on the South Fork, said on Tuesday that the two parties “continue to negotiate in good faith.”

“We feel we’re making progress,” she went on to say. “There are some fundamental issues to be resolved, but we’re feeling optimistic.”

Since August 1, the Alliance hospitals have been operating out of network after previous attempts to reach an agreement failed. Health care reimbursement rates, the amount of money insurance companies pay hospitals and doctors for various types of care given to policyholders, have been a major sticking point. Previously, Alliance had argued that Empire must raise its reimbursement rates to levels comparable with other insurance companies in the region, while Empire had argued that higher rates would result in higher premiums for subscribers. The impasse has affected many municipalities that use Empire to cover its employees and retirees, including Southampton, Riverhead and East Hampton towns, and Southampton Village. Suffolk County government alone has more than 48,000 employees, retirees and beneficiaries who subscribe to Empire.

During the out-of-network period, most Empire subscribers have been unable to use their health plans at Alliance hospitals for anything other than emergency care and approved procedures and treatment. Seniors subscribing to Empire’s MediBlue plan are able to access hospital care thanks to a settlement reached by the parties on that plan in late August.

At various points during the lengthy negotiations, Empire and the Alliance have openly criticized and even launched advertising campaigns against each other. Numerous “quiet periods,” in which both sides agreed to not speak to the media about their dispute, have come and gone. The last expired in late October and was followed by renewed public comments from Alliance and Empire spokespeople, each arguing that the other was at fault. The latest comments represent a considerable change in tone.

“Talks having been moving in the right direction,” Mr. Connor, who is the CEO of Eastern Long Island Hospital, said this week. “But I don’t want to build false expectation. The rosy picture is that we have seen progress.”

Negotiations are expected to continue this week.

While optimistic, Mr. LaValle cautioned against jumping to conclusions.

“I always refer to a quote by Yogi Berra,” he said. “It ain’t over till it’s over.”

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It would be such a relief if this could be settled and my insurance would once again be accepted. I just hope my premiums won't skyrocket!!!
By Mrs.Sea (268), Sag Harbor on Jan 27, 10 3:31 PM
keep hoping
By razza5350 (1911), East Hampton on Jan 27, 10 4:03 PM
They'll announce a deal at the same time they announce a rate increase. Because of all of the uncertainty I canceled my blue cross and moved to Aetna. Aetna has announced they will drop 600,000 clients to increase profits and now I receive a letter from Stony Brook that they may no longer be accepting Aetna!

Real reform now.
By peoplefirst (787), Southampton on Jan 27, 10 5:13 PM
Look at this! We're on the same side of an issue!

AETNA has been horrible!
By Frank Wheeler (1826), Northampton on Jan 28, 10 1:46 PM
Real reform HA! Does that include closed door negotiations, back room door deals, and the transparancy we were promised. I don't care who is providing voverge (INS companies or the GVT) until you can reduce the cost of care premiums will NEVER decrease.
By razza5350 (1911), East Hampton on Jan 28, 10 12:12 PM