MORGANTOWN — WVU Health System and Wheeling-based nonprofit managed care organization The Health Plan have terminated an agreement, announced in May, to operate as a single entity creating “a fully integrated healthcare delivery and financing system for the people of West Virginia,” as they termed it in May.
The Health Plan announced the termination in a Wednesday press release. The Health Plan spokeswoman Wendy Hodorowski said in a phone interview that it was a mutual agreement between both parties.
However, a new agreement may be forthcoming, according to WVU Health System.
Hodorowski said The Health Plan is committed to building a statewide integrated healthcare and delivery network that includes all health systems – CAMC and Marshall, for example – not just WVU Health System.
When the agreement was announced in May, both parties said studies have found that establishing a fully integrated network such as this – linking payor and provider – can help the U.S. healthcare system achieve the triple aim of healthcare reform: providing better quality care at a lower cost while focusing on population health.
Albert Wright, president and CEO of WVU Health System, which operates as WVU Medicine, said then that the only way to get true healthcare cost control and coordination is when the payor and provider are aligned.
The traditional healthcare model rewards the payor for withholding pay and rewards the provider for treating sick people, he said then. This integrated model aligns their goals; they’ll still treat the sick but they’ll also emphasize prevention and wellness.
The Dominion Post sent WVUM some questions about the termination, including why it happened and what’s ahead.
WVUM said, “We have no further comment at this time.”
But a Tuesday statement from WVUM foreshadowing the announcement also indicates another agreement may emerge.
“Both The Health Plan and WVU Medicine continue to believe that coming together is critical, as both believe they can better manage the healthcare challenges of West Virginia more effectively together than apart,” WVUM said Tuesday.
“To that end, they both remain committed to building an integrated healthcare finance and delivery network, one that will allow for the better coordination of care and management of the population’s health. As they continue to work towards that goal, they have agreed to move away from the original transaction, and are going back to the drawing board to make sure the partnership is the ultimate win-win and that each is optimally positioned to enter this new model of providing healthcare in West Virginia.”
The Health Plan, which has offices in Morgantown, Charleston and Massillon, Ohio, and insures more than 200,000 people, said it has informed the state Offices of the Insurance Commissioner about the termination.
Mon Health System and MedExpress have contracts with The Health System, as does CAMC, though CAMC was contemplating ending its contract with The Health Plan because of the WVU agreement, according to news reports.
The Health Plan said the terminated agreement does not change or affect coverage for anyone insured by The Health Plan who receives services from WVUM facilities.
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