Dean’s loss likely to be Mercy’s gain
Based on its new national contract with the United Auto Workers, the automaker has eliminated contracts with all of its preferred provider organizations and the majority of its health maintenance organizations in an effort to reduce the billions of dollars it spends each year on health care benefits.
In Janesville, that decision will make the access of hourly workers, retirees and their dependents to Dean Health System more expensive. Dean’s HMO now covers nearly 5,000 people in a contract with GM that expires Dec. 31.
“It was purely a business decision made at the corporate level,” said Michelle Bunker, a GM spokeswoman. “The HMOs just weren’t competitive.”
Starting Jan. 1, GM workers and retirees have two options: the MercyCare HMO or a Traditional Care Network offered by Blue Cross Blue Shield of Michigan.
GM currently has about 3,400 people covered by plans at Mercy, which has a network that includes 64 facilities in 24 communities in southern Wisconsin and northern Illinois.
Blue Cross Blue Shield is the largest health benefits company in terms of commercial membership in the United States. Through a nationwide network, it provides a variety of health care plans and related services.
Hourly employees who select the MercyCare HMO will not have coverage at Dean clinics. Those that choose the BCBS plan will have access to Dean services, but they will pay out-of-network prices.
Mercy’s HMO is one of only four that GM retained in its health care benefit package for hourly workers, said Javon Bea, Mercy’s president and chief executive officer.
“We’ve had a longstanding relationship with both General Motors and the UAW, and we’re pleased that we’ll be able to continue that as the exclusive HMO provider to the hourly employees in Janesville,” Bea said.
Mercy recently was named one of five organizations to receive the 2007 Malcolm Baldrige National Quality Award, the nation’s highest presidential honor for organizational performance excellence.
Bea suspects that played a role in Mercy’s survival among GM’s HMO cuts.
“Their Cadillac division won the Baldrige award, so they know what’s involved, and they, too, put a lot of emphasis on quality,” he said.
Bea said Mercy has been preparing for the new contract with GM for months. Mercy mapped the homes of all GM workers to see how they fit into the health system’s network and where staffing additions would be necessary.
“They’re pretty dispersed, but so are we,” he said, adding that Mercy would provide a special hotline available to UAW members seeking expedited appointments. “We looked at a grid and did some moving and shifting, but it didn’t really require all that much.
“We’ll be able to accommodate them without much of a shift in our personnel.”
With the potential loss of patients that switch their insurance to MercyCare, Dean and its Riverview Clinic in Janesville have not considered staffing adjustments, said Paul Pitas, Dean’s director of corporate communications.
Dean’s HMO will continue to cover 1,200 salaried GM workers, retirees and their family members, he said. Those employees are not subject to the national UAW agreement ratified in October.
“We’ll continue to leave the door open with GM and will continue to offer services to those who seek them out through the Traditional Care Network,” Pitas said.
Last updated: 11:07 am Thursday, December 13, 2012