CHARLESTON, W.Va. — State Public Employees Insurance Agency Executive Director Ted Cheatham says Charleston Area Medical Center’s decision to terminate its contract with The Health Plan won’t have a major impact on the state-run health insurance program.
“We looked at CAMC data with The Health Plan and I think less than a thousand people got admitted to the hospital at CAMC over the last 12 months,” Cheatham told MetroNews. “The people that have access to CAMC are one thing, the people who have needed to use it are another.”
CAMC and The Health Plan, headquartered in Wheeling, end their agreement at the end of the calendar year which will impact those in the private sector that have the plan but Cheatham was able to convince the two entities to continue their agreement with PEIA through the end of June 2020.
“Both of them understood my concern and the concerns of our constituents we serve in continuing out the contract year so they both agreed to continue it on,” Cheatham said.
PEIA recipients will still be able to choose The Health Plan for their coverage network in the future, they’ll just have to know that CAMC won’t accept it, Cheatham said.
“In the new plan year, people can still continue to select The Health Plan throughout the state of West Virginia, including Kanawha County. They just need to be aware that if they select The Health Plan and they live near Kanawha County they will not be able to get services at CAMC Hospital,” Cheatham said.
Thomas Health Systems, which operates Thomas Memorial Hospital in South Charleston and St. Francis Hospital in Charleston, has had a long-standing agreement with The Health Plan and that will continue, Chief Medical Information Officer Dr. Matthew Upton said.
“We wanted to make sure that the community was aware that Thomas Health was here for them. We’ll provide all the services they need so they won’t miss a beat,” Upton said.
Thomas Health has more than 300 physicians on its medical staff. Upton said there has been some confusion since the termination announcement was made.
“I was getting calls and texts from employees, employees’ spouses, friends of mine who are in The Health Plan of West Virginia who were getting very concerned they weren’t going to have health care in the (Kanawha) Valley and that’s not the case,” Upton said.
The Health Plan President Jim Pennington told MetroNews last week CAMC decided to terminate with his company because The Health Plan has agreed to become a subsidiary of WVU Medicine.
“CAMC sees that as an aggressive play on WVU’s part. In our meeting they called them ‘the northern aggressor’ several times,” Pennington said.
CAMC is the only hospital to send The Health Plan a termination notice.
CAMC claims it has been trying to work with WVU Medicine for the last three years on a collaborative agreement but WVU decided against it.
“Mr. Wright (WVU Medicine President and CEO Albert Wright) has been publicly presenting in multiple forums that he believes West Virginia should have only one health care system, and that WVU Medicine is the only organization that can provide the needed levels of specialty care. We strongly disagree with this sentiment. CAMC continues to focus on initiatives that benefit the citizens of West Virginia, including quality specialty services,” CAMC said last week.