ALBANY, N.Y. – November 21, 2024 – CDPHP and Albany Med Health System (AMHS) are in active discussions regarding our contract renewal. Over the last several weeks, we believed the parties were negotiating in good faith with the goal of reaching a fair and equitable contract agreement that avoids any disruption in care for our members.
“Unfortunately, the leadership of Albany Med has decided to take these negotiations public when both parties had committed to ongoing discussions. In addition to numerous factual inaccuracies in their statement, the actions by the leadership of Albany Med are in direct violation of the confidentiality agreement the parties entered into no more than 10 days ago while trying to amicably resolve this dispute. Their statement today is nothing more than a blatant attempt by a large hospital system to bully CDPHP and unnecessarily alarm our members and their patients. As a not-for-profit, community-based health plan, our focus is to ensure that our members are provided high quality health care at an affordable price. We find these actions unfortunate because they put you – the patients – in the middle of normal business discussions. Their actions today are nothing more than a shameful attempt to bully the health plan and alarm and confuse our members who are their patients.” said CDPHP president and CEO, Brian O’Grady.
Contrary to their contention, there is no imminent crisis. Though our contract termination date is December 31, 2024, there is a state mandated 60-day “cooling off” period where all members can continue to receive care at AMHS facilities until March 1, 2025. In addition, if you are currently in an ongoing course of care, that period is extended for another 30 days. This period allows for several more weeks of negotiations between our organizations, therefore, there is no reason for members to worry.
The Medicare Wage Index
While negotiations between hospitals and health plans are a normal part of business practices, our discussions are complicated by the fact that CDPHP and its competitors are facing financial hardship due to the Medicare wage index. This regulation granted hospitals in Upstate New York a windfall of $1 billion. Unfortunately, federal regulators failed to align private Medicare Advantage premiums with this adjustment, leaving CDPHP with a significant unfunded mandate that will result in nearly $145 million in losses over the next two years. The issue is exacerbated by the fact that CDPHP has increased current and prior year commercial rates to supplement historically low Medicare rates.
CDPHP stopped paying this new, unfunded mandate in order to protect your benefits and out-of-pocket costs for members. CDPHP does continue to pay our hospital partners at the rates agreed to prior to this unfunded mandate. That means, your care is covered, and your claims are being paid.
CDPHP recognizes the tremendous value AMHS offers our community, and we are committed to reaching a fair and equitable agreement.
###
About CDPHP®
Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 36 counties throughout New York. CDPHP is also on Facebook, X, LinkedIn, and Instagram.