Altoona Regional Health System and HealthAmerica reached a contract agreement Monday that will ensure 3,500 regional subscribers can continue to patronize the hospital and affiliated companies without incurring out-of-network charges.
The hospital threatened to terminate the agreement by which the insurance company reimburses the hospital for services rendered to subscribers Sept. 26, according to HealthAmerica.
HealthAmerica claimed the hospital demanded "an exorbitant increase," but the hospital said it merely wanted "fair payment."
The hospital long has complained about reimbursements, especially from Medicare and Medicaid, which it says don't cover costs.
The hospital relies on reimbursements from private insurers to help offset the losses.
The hospital ended its recently completed fiscal year with an operating deficit of about $2 million.
The joint statement about the settlement with HealthAmerica failed to answer questions about the new level of hospital reimbursement, how it may affect premiums for policyholders and employers and how the deal got done.
Asked whether HealthAmerica policyholders exerted pressure on doctors to push both sides to settle, an employee at Fairway Primary Care said "our doctors said they haven't heard anything."
Blair Gastroenterology heard from some HealthAmerica policyholders but directed them to the insurance company for answers, Blair Gastro administrator Felix Mariani said.
The new contract is multiyear.
