ALBANY, N.Y., February 6, 2025 — The Albany Med Health System and CDPHP announced today the organizations have agreed on a new two-year contract which keeps the system in-network and avoids any disruption in care for CDPHP members. Separately, CDPHP has also agreed to reimburse the system for care provided to the insurance company’s members in 2024. The proposal was approved by the Albany Med Health System Board of Directors.
“We are grateful to reach an agreement that preserves our valued patients’ access to the high-quality care they expect and deserve,” said Albany Med Health System President and CEO Dennis P. McKenna, MD. “Many of the advanced services we offer cannot be found anywhere else locally. This agreement recognizes the indispensable role our Albany Med hospitals and health care teams hold in the health of our region. It also acknowledges what is required to provide that care to the people we serve.”
In August 2024, CDPHP notified Albany Med of its intent to begin withholding payments related to the Medicare Wage Index. The withhold related to a new federal rule, which after nearly 40 years of reimbursements at a lower rate for hospitals, increased Medicare payments to hospitals without a corresponding increase in Medicare Advantage payments received by CDPHP and other insurance providers. The rule created a new, unfunded mandate for small, regional health plans, like CDPHP, which provide coverage to patients under private Medicare Advantage plans. By December 2024, CDPHP had withheld $30 million in payments related to the wage index. As part of the agreement, CDPHP will pay Albany Med for the withheld amounts, and Albany Med has dropped its lawsuit against CDPHP.
CDPHP President and CEO Brian O’Grady said the insurer is committed to a contract that covers the necessary cost of care and to collaborating with the Albany Med Health System to maintain and elevate access to care moving forward.
“As a not-for-profit health plan with deep roots in our community, we are grateful to the Albany Med Health System for coming to the table and arriving at a solution that protects those who matter most – our members and their patients. This fair and equitable contract ensures uninterrupted access to critical health care services,” O’Grady said.
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About the Albany Med Health System:
Comprised of Albany Medical Center, Albany Medical College, Columbia Memorial Health, Glens Falls Hospital, Saratoga Hospital, and the Visiting Nurses, the Albany Med Health System is the largest locally governed, not-for-profit health system serving northeastern New York and western New England. The System is the region’s largest private employer, and each member institution carries a century-long tradition caring for our communities. The Albany Med Health System has 1,520 hospital beds, more than 800 physicians, 125 outpatient locations, a children’s hospital, and research enterprise serving the three million people of our region.
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.
Updated February 6, 2025