Baptist, Community Health Alliance Strike Deal

By Jennifer Johnson Backer

West Tennessee residents who purchase health care insurance through Community Health Alliance beginning this fall will be directed to providers at Baptist Memorial Health Care facilities.

Memphis-area residents who purchase health insurance through Community Health Alliance will be directed to the 14 hospitals in the region operated by Baptist Memorial Health Care Corp.

(Baptist Memorial Health Care Corp.)

The exclusive agreement should be a boon for the Memphis-based Baptist system, which operates 14 hospitals in West Tennessee, North Mississippi and eastern Arkansas. The Baptist network also includes more than 4,000 affiliated physicians, a multi-specialty physician group of more than 450 providers, home, hospice and psychiatric care, and a network of surgery, rehabilitation and outpatient centers.

Many plans sold on the health care exchanges will offer fewer choices of health-care providers in an effort to bring down premiums and overall costs. Some insurers are pushing hospitals to grant discounted rates in exchange for narrower networks that will drive more patients to specific hospitals. Under the health care reform law, Americans will be required to have insurance beginning Jan. 1 or pay a penalty. In Tennessee, about 900,000 people did not have insurance in 2011, according to U.S. Census data.

“This partnership is a first for our region, and our goal is to offer greater access to health care by providing affordable options,” said David Elliott, vice president of managed care for Baptist Memorial Health Care.

Knoxville-based Community Health Alliance was created with a $73 million federal loan in August 2012. The health insurance CO-OP (consumer operated and oriented health insurance plan) was created by the Affordable Care Act to provide competition to other health insurance carriers.

Unlike a traditional insurance carrier, policyholders can elect the board of directors and all insurance premiums are used for the benefit of members.

Community Health Alliance has said plans and rates won’t be available until Oct. 1, when consumers will begin to shop for plans on the new Tennessee Health Insurance Marketplace mandated by the Affordable Care Act. Community Health Alliance health care coverage will begin Jan. 1.

Four other companies have filed to offer health insurance products on the Tennessee exchange, including BlueCross BlueShield of Tennessee, Cigna, Humana and Coventry Health & Life, the Tennessean reported on May 8. The plans still require approval from the U.S. Department of Health and Human Services before they can begin enrolling patients. Many residents will be eligible for subsidies to help pay for insurance premiums.

While some plans will have narrower networks, Elliott said the Community Health Alliance partnership with Baptist also focuses on delivering quality care.

“We have developed in partnership with our physicians over the last year a clinically-integrated network where we work closely with our physicians to improve the quality of care and that is also a goal of Community Health Alliance,” he said. “Narrower networks all by themselves do not do anything to improve the quality of care for the patient.”

The Community Health Alliance agreement with Baptist is one of many managed care partnerships the CO-OP is developing across the state as it assembles a network of preferred providers.

“This is another important milestone for Community Health Alliance, and we couldn’t be more pleased to have Baptist Memorial Health Care as part of our hospital network,” said Jerry Burgess, Community Health Alliance CEO.