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Agreement allows 90,000 in NEPA to choose services in Geisinger Health Care system.
About 90,000 residents covered by Blue Cross of Northeastern Pennsylvania’s First Priority BlueCare HMO and BlueCare HMO Plus are now able to choose a doctor in the Geisinger Health Care network and head to a local Geisinger hospital for care.
After months of negotiations, Blue Cross announced Wednesday that an agreement has been reached with more than 300 Geisinger physicians and both the Geisinger Wyoming Valley and Geisinger South Wilkes-Barre hospitals that will now accept its two HMO plans. They already accepted plans in Blue Cross’ First Priority Health provider network.
Anthony Matrisciano, a Blue Cross spokesman, said the decision was made “to expand the choices for our members. That’s what it comes down to.”
He said Blue Cross heard from many of its members about the lack of Geisinger physicians’ participation and their wish for changes. The company obliged.
He denied that the ongoing health care controversy and proposals for a public option and government involvement in the system had anything to do with the move.
Geisinger also heard from those Blue Cross customers.
“Patients with First Priority BlueCare HMO and BlueCare HMO Plus have approached us numerous times expressing their desire to utilize our doctors and facilities for their health care,” said Dave Jolley, spokesman for Geisinger Health System. “Our goal is to make Geisinger quality services available to as many people as possible, and this agreement helps us to reach a segment of the market that previously did not have access to Geisinger.”
Jolley said the two companies chose to work together for the good of the patients.
There are some stipulations to the agreement between the two regional health care giants. Among them are that Geisinger Medical Center in Danville and its affiliated physicians are not included in the deal.
Also, customers with primary care physicians based in Lackawanna or Luzerne counties need to have outpatient laboratory work done at Pennant Laboratory affiliates only. This includes Wilkes-Barre General Hospital, but not the two Geisinger hospitals in Luzerne County.
Also, if a patient’s primary care physician is based in Luzerne County, excluding the Hazleton and Berwick areas, radiology procedures must be done at Wilkes-Barre General Hospital, the Thomas P. Saxton Medical Pavilion in Edwardsville or another outpatient radiology site already included in the health plan.
Matrisciano said there are no rate increases resulting from the agreement.