RHC: Holy Cross Hospital

Contact: Sister Sally Maloney
Telephone: (716)-828-2750

The Catholic IPA, which represents over 750 Catholic Health System-affiliated physicians, was established to serve as a vehicle for partnering between the Catholic Health System and its medical staff for managed care contracting, strategic planning and other activities associated with Catholic Health System/physician integration activities.

These activities are designed to ensure that quality services can continue to be provided to the patients served. In addition, these activities help improve the ability of health care providers to effectively cope with the market environment and maintain adequate levels of reimbursement for services provided, as well as maintain and enhance the physical and financial state of the health care delivery infrastructure (facilities, services, systems and programs).

As a significant commitment to working with the medical staff on the part of the Catholic Health System governance body, the Catholic Health System has formally delegated the responsibility and authority for all managed care contracting decisions to the Catholic IPA.

· In October of 1998, Catholic IPA and Blue Cross and Blue Shield of WNY reached agreement on a four-year contract. The agreement assures that 525,000 Blue Cross and Blue Shield members will be able to maintain their relationship with the Catholic Health System and its Catholic IPA physicians through the year 2002.

· In December of 1998, the Catholic IPA and the Erie County Medical Center (ECMC) Healthcare Network entered into an innovative contractual agreement which enables ECMC to participate in managed care negotiations and risk contracts which involve the Catholic Health System.

The inclusion of ECMC into the hospital network offered by the Catholic IPA, enhances the ability to negotiate managed care relationships which support efforts to preserve an integrated, quality health care delivery system and array of services necessary to meet the needs of the community, and is a major step towards making health care in Western New York more cost-effective.

· Effective January 1, 1999 is a risk-sharing contract that was reached with HealthCarePlan for their Medicare Managed Care plan, SeniorChoice. This contract has increased significance with the conversion of nearly 9,000 former Encompass 65 (Independent Health) Medicare Managed Care members to SeniorChoice during the final quarter of 1998 in response to changes in their plan’s accessibility to the Catholic Health System.