Christie can't take all those whose insurance would change
CHAMPAIGN -- Where will state employees and retirees who are patients at Carle turn if many of them have to switch doctors because of an insurance change?
Champaign County's other big physician practice would have room for only a fraction of them.
Christie Clinic is accepting new patients all the time, and some of the state employees could find a new medical home there, says its CEO Alan Gleghorn.
"Could we take a couple of thousand or a good number? Probably," he said. "But the numbers they have been speaking of, we would not be able to handle that."
How many Carle patients would go looking for a new doctor if a Health Alliance HMO isn't available to state members is unknown, but the potential is huge: Health Alliance says 23,916 state employees, their dependents and state retirees are currently patients of Carle physicians, and the other insurance options that would allow them to keep their Carle doctors would be more expensive.
Neither Carle nor Christie Clinic accept the two new HMOs being offered by the state through Blue Cross and Blue Shield, and Carle doesn't accept the HMO-like options state members are being offered through the new three-tier Open Access Plans.
Gleghorn said Christie is a Blue Cross provider, but only for a Blue Cross PPO health plan.
Christie Clinic will, however, accept all three tiers of coverage being offered by the new PersonalCare and HealthLink Open Access Plans, including tier one HMO-like coverage.
Because Carle has an exclusive HMO arrangement with Health Alliance, it would accept only the lower two tiers of the Open Access Plans, and both have been billed as more expensive for state members.
Christie Clinic's Chief Financial Officer Kenny Bilger said Christie Clinic is all about offering the community choice and having the broadest possible provider network.
"The decision to exclude HAMP (Health Alliance Medical Plans) isn't ideal for the community," he said.
"Christie has always liked to offer choices in the community," Gleghorn said. "But the state is not offering choice to the community here with the decision that they've made."
Gleghorn said the state never consulted Christie Clinic about its capacity for adding new patients when the insurance decisions were made. Nor has Christie been contacted by Blue Cross about becoming a provider for the new state HMOs, he said.
Because of Blue Cross' typical reimbursement rates, Gleghorn said, Christie Clinic probably wouldn't be signing up. But, he also said, "we'd certainly take the call."
MoreI am really disappointed that the news is making the state out to be the bad guys here, it sounds like in a budget crisis, they are trying to save us money. If Health Alliance and Carle are too big to adjust to the realty of the rest of us by accepting other insurance then like the rest of us they should live with the consequences. The state did exactly what all medium to large businesses do, ask for a price on insurance for their employees. If Carle and Health Alliance are to big to give a competitive price then they should loose the business, anyone who has ever bid a job knows that you better put your best foot forward if you want the business, especially with the state. If you didn't do it, then blame yourself. Don't cause added expenses for all of the taxpayers by making the government defend it's bid procedure in court. It's simple, you bid, you lost, try again next year.
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