ALBANI — Residents of the metropolitan area are once again in the midst of a dispute over reimbursement rates between the largest health insurer in the Albany area and St. Peter’s Health Partners, one of the region’s largest health care providers.

Dueling notices are sent out by St Peter Health and CDPHP partners – who must agree to what the health insurer will pay to doctors, hospitals and other providers in the health care network by December 31 – advising their patients to either start looking for a new insurance provider or find a new doctor .

The CDPHP Building on Patron Creek Boulevard.  In Albany, NY, Wednesday, June 5, 2013 (John Karl Danibali/Times Union)
The CDPHP Building on Patron Creek Boulevard. In Albany, NY, Wednesday, June 5, 2013 (John Karl Danibali/Times Union)
John Karl Daniel

Peter's Hospital on Tuesday, June 5, 2022 in Albany, New York The hospital is merged with St. Joseph's Hospital in Syracuse.
Peter’s Hospital on Tuesday, June 5, 2022 in Albany, New York The hospital is merged with St. Joseph’s Hospital in Syracuse.
Laurie Van Buren/Times Union

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The letter came out from St. Peter first, warning patients that St. Peter and all of its affiliated medical practices could be out of the network for CDPHP plans and noting that the open enrollment period for health insurance would begin soon. Lists 10 insurance companies that will continue to cover services in St. Peter.
A spokesman for St. The cost of providing care to residents of the metropolitan area.
But the CDPHP, which has presented its own note to its members, insists that discussions are ongoing and maintains that St Peter’s Hospital is using patients as a negotiating technique.
“We have several months to find out. So it’s very disappointing to us that St. Peter – and this isn’t the first time they’ve done this – have chosen to put their patients in the middle of very routine discussions,” said CDPHP spokeswoman Alessandra Skinner.
The CDPHP notice accuses the hospital system of submitting a bid to its parent company, Trinity Health of Lavonia, Michigan, one of the nation’s largest health care conglomerates, which posted a $1.4 billion shortfall for the fiscal year ending June 30.
The CDPHP notice reads: “The Michigan-based healthcare giant is trying to balance its books on the backs of hard-working metropolitan area residents, small and large businesses and seniors living on a steady income.”
While the contract expires on December 31, there is a 60-day grace period during which members can continue to receive care at St. Peter’s facilities, the CDPHP notes. For patients who are pregnant or have chronic health needs, that period is extended for another 30 days, until the end of March 2023.
The insurance company claims that St. Peter’s is asking for exorbitant price increases on an annual basis, which translates into higher costs for its members at a time of skyrocketing inflation. Much of its members are Medicare, Medicaid and small business employees, whose rates are set by the state, leaving little room for premium increases, according to Skinner.
The company faces St. Peter’s Health Partners, which operated by slim margins before the COVID-19 pandemic, has faced serious budget challenges caused by the coronavirus. A hospital spokesperson denied Trinity was involved in the discussions.
“Like most nonprofit health systems across the country, we are doing everything we can to weather the lasting impact of COVID-19, the current economy, the rising costs and the significant workforce shortages we all face,” Webster said.
Termination of the contract would deal a blow to St Peter’s, which counts on the potential business of 400,000 CDPHP patients. It would also hurt the insurance plan, which would be less attractive to subscribers if it did not cover care in St Peter’s network of six hospitals.
Both organizations said they hope to find a solution.

The last time negotiations were announced, in 2016, St. Peter’s and CDPHP web pages compete for the loyalty of their patients.
John W. Huberts, professor emeritus at Clarkson University School of Business in downtown Schenectady, said the hospital system could benefit most from the publicity of the dispute.
“In the last 20 or 30 years, we’ve seen that people are loyal to their providers and their doctors – not necessarily individual St Peter’s as a brand – but they’d rather stay with their doctors and look for the latest treatment plan.”
He said it was rare for negotiations to become public and there was a lot of pressure on both sides to find a solution.
Huppertz said that if CDPHP and St.
When contract disputes become public, they are usually resolved before the termination deadline, but there have been exceptions.
“I think they’ll come to some sort of agreement in the coming months, things will get back to normal, but there’s always a chance that won’t happen,” Huberts said.

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