St. Peter’s Health Partners, CDPHP locked in dispute as patients wait for answers
Contract negotiations between two major regional health care companies have some patients and subscribers on the edges of their seats.
CDPHP and St. Peter's Health Partners have been at an impasse over a contract agreement involving reimbursement rates. A cloud of uncertainty is hanging over thousands of patients, many of whom have been sent letters warning they may have to find a new health care provider or may have to switch to a new insurance company.
St. Peter's Chief Clinical Officer and Chief Operating Officer Dr. Steven Hanks says the angst among patients is understandable, as negotiations with CDPHP continue.
“We've had an incredible inflation in the cost of the care delivery, primarily driven by the overall general rate of inflation of all goods and services, but in particular for us, in health care labor costs," said Hanks. "Nursing base wages are up over 20% in the last year. Premium incentive payment is up, it's more than double what it was a year ago. Staff shortages are critical in all of our hospitals, and we're relying on expensive agency nurses in critical areas to keep critical services available. Those rates have increased 300% in one year. So add to that the fact that we also have critical shortages in some critical physician specialties, and this just isn't a St. Peter's issue, or an Albany issue. This is a nationwide issue.”
CDPHP spokeswoman Ali Skinner says routine annual contract discussions were under way when...
"St. Peter’s inappropriately and prematurely sent letters to their patients and our members, letting them know that we're in the middle of these contract discussions," Skinner said. "And, you know, make no mistake about it, we're in the middle of what's called open enrollment. That's the time a year when, you know, individuals select their health care coverage, seniors select their Medicare Advantage plan. So it's nothing more than a negotiating tactic on behalf of St. Peter's to really put their patients in the middle and try to use that as leverage in these contract negotiations.”
The existing agreement between the two entities expires January 1st. A similar tiff happened in 2016 and was settled in early December. This time around Skinner says Trinity Health, St. Peter's’ parent company, has demanded a 19% rate increase
"It's also important for folks to know that St. Peter's Health Partners broke even last year, they're not for profit, that's what they're supposed to do," Skinner said. "CDPHP is also a not for profit, so we don't anticipate making money on the business. But unfortunately, what we know about Trinity Health is that they lost $1.4 billion last year. Trinity Health based in Livonia, Michigan lost $1.4 billion last year. And they're truly coming to the Capital Region and looking to balance their books on the backs of our local community, and we can't allow that to happen."
Skinner says the current contract is in place until December 31st.
"There’s a period called cooling off," said Skinner. "And that means that for 60 days, after our contract expires, any CDPHP member can continue to go to a St Peter's hospital, all the way up until the end of February. More importantly, if you're on an ongoing course of treatment at the hospital, or if you're pregnant, you have much longer to go. So if you're in an ongoing course of treatment, you can continue to go to St. Peter's hospital all the way up until April 1. And if you're pregnant, you can continue going to the hospital until you deliver and then even continue receiving postpartum care.”
Dr. Hanks says he is "very optimistic" the two parties will soon reach an agreement.
"Negotiations are ongoing," Hanks said. "I've sensed in the last seven to 10 days and improvement in the pace of the discussions. And although we still have to make available to patients all the information about what could happen if we're out in network for any period of time, if there is no contract in place on January one, and that is very unsettling, that's kind of a necessary step we need to do in order to assure that people are fully informed. The reality is the community needs both St. Peter's Health Partners and CDPHP. And the leadership of both St. Peter's health partners and CDPHP understands this, and we're working very, very hard to reach an agreement so that we will not have service disruptions.”
Skinner says CDPHP also anticipates reaching an agreement and avoiding any disruption in members' care.