BWH and the BWPO, along with the rest of the integrated Partners HealthCare System, recently finalized negotiations with Private Healthcare Systems (PHCS), a multi-client PPO covering approximately 200,000 members in Eastern Massachusetts. PPOs, or Preferred Provider Organizations, are contracting entities that rent out their network of providers, and the rates they have negotiated, to various self-insured employers and other insurers.
As a reult of the negotiations, BWH and the BWPO were able to establish favorable reimbursement and non-rate terms. For example, PHCS will now adhere to a higher and more consistent physician fee schedule, one which is more uniform for each specialty. In addition, PHCS agreed to prompt payment guidelines, the ability to terminate individual clients (as opposed to terminating the entire contract), and a 90-day prior notice on policy and procedure changes, among other negotiation issues of importance to the BWPO and BWH.
“We are very pleased with the results of the negotiation and see it as another successful outcome of the BWPO strategy for improving physiciancompensation. This is a non-risk deal that could not have been negotiated collectively on behalf of BWH physicians prior to the formation of the BWPO,” said Andy Sussman, chief medical officer, BWPO.
Negotiation terms were effective May 1. For more information on the negotiations with PHCS, call Managed Care Contracting at ext. 2-9580.