By: Health Insurance
Submitted: 2009-12-04 12:57:18 | Word Count: 591
State employees who like their St. John's network doctors will get to keep them for at least another year under a deal reached this week The board of Missouri Consolidated Health Care Plan voted Tuesday to allow 9,000 state employees to chose between an HMO-like health insurance plan with Mercy Health Plan or three options from United Healthcare for 2010.
The health care administrator for state employees had intended to move all employees in the south-central and southwest regions into United Healthcare plans in the CoxHealth system.
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But that plan was abandoned, in part, because of backlash from state employees who didn't want to switch from St. John's to Cox doctors in order to save the state money.
"There were a lot of employees that were upset because we were making this change from Mercy to United and that was going to change their provider from St. John's to Cox," said Sen. Frank Barnitz, a Dent County Democrat who serves on Missouri Consolidated's board.
Enrollment for the three United Healthcare plans and one Mercy plan will be reopened for one week, starting Nov. 30, said Rick Bowles, executive director the Missouri Consolidated Health Care Plan.
Bowles said an effort was made to get United Healthcare to accept St. John's doctors into its networks.
But that deal fell through because St. John's had exclusive contractual obligations with other insurers, Bowles said.
"We didn't see any way people were going to be able to work together because of all of the contract issues by January 1," Bowles said. "After looking at the situation, I think that they're going to be best served by having more options in that region than they did have."
Under the agreement, Mercy will extend its 2009 contract for a year. Missouri Consolidated will put the provider contract back up for bid next year with hopes that St. John's and Cox -- and their respective insurers -- can work out an arrangement accepts state workers between the two health care networks.
Nearly all members of Missouri Consolidated in the region will be eligible for the new open enrollment period, except for a couple of isolated employee groups, Bowles said.
Barnitz said Mercy has agreed to reimburse at the rate United bid on originally for the 2010 contract.
Bowles said the deal will not cost the state more money next year, but it won't produce the savings the health care plan needed to make either.
"We're actually saving a little bit of money, but it's not something I can expect to duplicate next year," he said.
Bowles became executive director of Missouri Consolidated less than three weeks ago after serving as senior vice president of Ingenix, a health care technology company, where he was involved in management consulting for health care plans.
He said officials from Cox, St. John's, United and Mercy pledged to work together so state employees can still choose which doctors and specialists they want to use.
"I'm holding them to their word that they want to do this and hopefully over the next year we'll have a chance to meld these two great health care groups together," Bowles said.
