Partners ends relationship with Tufts- BWH Bulletin - For and about the People of Brigham and Women's Hospital
Partners ends relationship with Tufts- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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October 27, 2000
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In This Issue:
Ramzi S. Cotran, MD 1932-2000
Partners ends relationship with Tufts
What are the HR Standards?
Do You Know What A Sentinel Event Is?
Generous Gifts Go A Long Way
Pike Notes
Thomson Leadership Award
BWH Town Meeting November 15 at 11 a.m.
Contract Unable to Cover Costs After months of negotiations, Partners physicians and hospitals announced Monday that they plan to end participation in the Tufts insurance plan as of April 1, 2001. Along with BWH, Partners hospitals joining in this decision include MGH, North Shore Medical Center, Newton-Wellesley Hospital, Faulkner Hospital, Spaulding Rehabilitation Hospital and the Partners Community HealthCare network. The Tufts senior plan, Secure Horizons, is unaffected. “Unfortunately, despite both parties efforts, Partners and Tufts we were not able to reach an agreement,” said Anthony Whittemore, MD, chief medical officer at BWH. “The financial pressures on BWH physicians and the hospital as a whole are such that we can no longer participate in contracts that don’t cover the cost of care.” The key issue in the negotiations was reversing chronic shortfalls in the amount Tufts reimbursement. Hospital and physician HMO losses on the Tufts contract totaled $42 million in just the past two years. The hospitals ran a 1999 deficit of 17 percent on the contract. Physicians have not seen their Tufts fees increase in five years. During that time, inflation and the cost of care have risen more than 13 percent, but Tufts reimbursements have not kept pace. To help minimize the impact on patients throughout the system, Partners is sending a letter to all Tufts patients, their doctors and their employers to alert them to this decision and to their options for continuing to be cared for by Partners physicians and hospitals. To provide information for both patients and Partners employees, a web site has been set up at www.partners.org/tufts, as well as a call center to answer questions. The call center number is 1-800-554-9545. If you work directly with patients, please check with your manager for informational materials to better answer patients’ questions. Similarly, Tufts health insurance plan will not be offered to BWH employees as of April 1. If you are currently enrolled in Tufts, you will soon receive a letter with detailed information about this change and your health coverage options. Sometime before April 1, BWH employees who are Tufts subscribers will be able to select an alternate health care plan. Employees may choose to stay in Tufts until April 1, or choose a different plan during the open enrollment period (Oct. 23-Nov. 6). “We understand that this is a very significant step, and we had hoped these discussions with Tufts would have been resolved successfully,” said Samuel O. Thier, MD, president and chief executive officer of Partners. “In the end, Tufts’ proposals were simply not adequate to fund the standard of care on which we pride ourselves. One reason we formed Partners was to protect our legacy of patient care excellence in the face of these challenges. This decision, while very difficult, is consistent with that founding goal.”