Ensures health plan’s membership has continued in-network access to health care at Kaleida Health facilities
Earlier this week, Highmark Blue Cross Blue Shield of Western New York and Kaleida Health announced a new agreement that ensures Highmark’s membership will continue to have access to Kaleida Health’s hospitals, facilities and services.
"Kaleida Health and Highmark Blue Cross Blue Shield of Western New York share long traditions of caring for our communities," said Dr. Michael Edbauer, president, Highmark Blue Cross Blue Shield of Western New York. "This new agreement ensures Kaleida Health, as a vital health care provider in our region, has the support needed to continue serving our members and community members.”
A press release stated, “As part of the new agreement, Highmark BCBSWNY will work with Kaleida to enhance its value-based reimbursement programs for preventive health care as part of its overall commitment to making health care affordable and accessible.
“Kaleida Health is the largest health care provider and the largest private employer in the area, and a major teaching affiliate of the University at Buffalo. It is affiliated with Great Lakes Health System of Western New York, the entity integrating Kaleida Health, Erie County Medical Center and the University at Buffalo.”
Kaleida Health President and CEO Don Boyd said, “As we continue to dig out from the pandemic, rebuild and reimagine health care in Western New York, it is vitally important to have partners like Highmark Blue Cross Blue Shield who will work with us to address quality, access and affordability for our patients. Doing that – rebuilding and reimaging this entity called Kaleida Health – will not be easy. Despite many declaring the pandemic ‘over,’ we are far from it. In fact, the financial and operations headwinds that we face are enormous for us and the entire hospital industry. So, the need to change will come fast. We must get creative, and we must be nimble. All that said, I am confident that, by working together with organizations like Highmark Blue Cross Blue Shield and our local payor community, we can get there.”
The press release noted, “Highmark Blue Cross Blue Shield of Western New York, as the region’s leading health plan, continues to offer the most comprehensive hospital and physician network in the region to their membership locally, as well as nationally through the Blue Cross Blue Shield ‘Blue Card’ program.”
Kaleida Health facilities have received the Blue Distinction Center+ designations by the Blue Cross Blue Shield Association (BCBSA) for the following:
√ Buffalo General Hospital, spine surgery
√ Buffalo General Hospital, cardiac care
√ Millard Fillmore Suburban Hospital, maternity care
√ Buffalo General Hospital, bariatric surgery
These designations are given by the Blue Cross Blue Shield Association (BCBSA) to only a select number of hospitals and health systems across the country based on quality and cost criteria. In addition, Kaleida Health facilities are also designated by BCBSA as Blue Distinction Centers for the following:
√ Buffalo General Hospital, knee and hip replacement
√ John R. Oishei Children's Hospital, maternity care
√ Millard Fillmore Suburban Hospital, knee and hip replacement
Specific terms of the contract agreement were not disclosed.
Kaleida Health is the largest health care provider and largest private employer (10,000 employees) in Western New York. More than 1 million patient visits are recorded annually at the Buffalo General Medical Center, Bradford Regional Medical Center, DeGraff Memorial Hospital, Gates Vascular Institute, Millard Fillmore Suburban Hospital, Oishei Children’s Hospital, Olean General Hospital, plus health system’s 80-plus clinics and health care centers. Kaleida Health operates HighPointe on Michigan and the DeGraff Memorial Hospital skilled nursing facility, plus the nation’s oldest – and original – Visiting Nursing Association. Kaleida Health also operates a major laboratory division as well as the Millard Fillmore Ambulatory Surgery Center. The organization is also affiliated with Great Lakes Health, the entity integrating Kaleida Health, Erie County Medical Center (ECMC) Corp. and the University at Buffalo. Kaleida Health's economic impact on Western New York exceeds $2.7 billion annually.
Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Since 1936, Highmark Blue Cross Blue Shield of Western New York has helped millions of people lead healthier lives. Blue Cross Blue Shield offers a full range of insured, self-insured, and government programs and services covering businesses, families and individuals, as well as dental and vision plans and stop-loss coverage. As a community-based, not-for-profit health plan, Highmark Blue Cross Blue Shield contributes significantly to organizations that strengthen and enrich the health of the community.