Carson hospital to terminate contract with Reno insurer

Carson City's largest health-care provider threatened to terminate an agreement with the insurer of thousands of state employees and retirees unless it reimburses more for costs, a hospital official said Friday.

This means Carson Tahoe Regional Medical Center would still accept Hometown Health insurance, but out-of-pocket costs could be higher to patients who are members of this program.

A Hometown Health insurance official said the reimbursement rates were agreed on by both parties when the contract was first signed.

Carson Tahoe Regional Medical Center was one of the top providers to Public Employees Benefit Program patients last fiscal year, and it was paid less per patient than other major area providers, said hospital spokeswoman Cheri Glockner.

Since July 2004, the North Carson City hospital has treated these program members, who have Hometown Health insurance, owned by Renown Health of Reno. It estimates that 4,500 state employees and retirees in the area are covered by this insurance.

"As a not-for-profit organization, we don't have the luxury of being paid low or inadequately for services rendered," Glockner said Friday. "We really want PEBP members to know we're working with Hometown Health Partners to renegotiate so there will be no disruption in service to PEBP members."

The contract will be terminated by March 15, unless a new agreement is reached, she said.

"Our primary concern is that there is no disruption in patient care for people potentially affected by Carson Tahoe's actions," said Troy Smith, vice president of Hometown Health, in an e-mail.

He said the company negotiated with Carson Tahoe Regional Medical Center in good faith and provides reimbursement rates that are competitive.

Hometown Health is the insurance arm of Renown Health, a Reno hospital and major competitor with the Carson hospital.

A transition plan for Public Employees Benefit Program members is being put in place in case the hospital is unsuccessful at negotiating acceptable terms with Hometown Health, he said. Program members will be entitled to a greater discount on their share of costs based on the hospital's guidelines for underinsured patients, according to the hospital.

The hospital officials said communication problems with the insurer are also a factor in terminating the contract.

The medical center treated the second largest number of their members from July 2005 through June 2006, yet was paid less per patient admitted than other major healthcare providers in Northern Nevada, according to program information submitted to Carson Tahoe Regional Healthcare.

• Contact reporter Becky Bosshart at bbosshart@nevadaappeal.com or 881-1212.

Hotline

Are you a Public Employees Benefit Program member?

A hotline has been set up by Carson Tahoe Regional Medical Center, to assist patients with accessing the hospital's services after the termination of the contract. Call 885-4727.