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Old 10-05-2011, 04:10 PM
 
35 posts, read 72,722 times
Reputation: 18

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Recent story states that they will no longer be doing organ transplants at any of their hospitals. Press release blames the economy and low patient volume,but the ONLY way that MSHA would stop doing organ transplants all together is if they got busted by the state and lost their certification OR if Medicaide/Medicare stopped paying for them. Anybody got the inside scoop? I find it kind of fishy that MSHA is offering to relocate any of their existing patients and offering to help with transportation costs....thats just not the kind of thing Mountain States does(unless they're in trouble)!
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Old 10-07-2011, 10:19 AM
 
9,620 posts, read 5,157,402 times
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Don't know about that, but did see where right now they are not planning on renewing their contract with Cigna on January 1. In fairness, these insurance/hospital contract disputes are not that unusual. Both sides just like using the media as a stick to beat the other over the head. Sort of how politicians use the media.
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Old 10-07-2011, 10:50 AM
 
Location: Johnson City, TN
218 posts, read 363,349 times
Reputation: 175
Medicare guidelines are very strict and I guess that MSHA feels they can not continue to do tranplants under the ccurrent guidelines and make money - Bottom line is, it is very expensive to maintain a transplant center and MHSA has not gained a reputation of being a transplant hospital like some in the region i.e. Vanderbilt, Duke, UVA Charlottesville. Offering to assist those who are curretly in the transplant stage is bonified and usual. MHSA is not going to take a hit because of this - so it is less expensive in the long run to help with costs to another facility rather than eat the initial cost of maintaining a transplant team. MHSA has had its surgical issues - i.e. MRSA infections is very common - but I don't think they are about to lose certification. -
The insurance issue is a game - you are so right earthlyfather. Cigna is not that big in this area - now if it were United HealthCare - I'd say we would have something to worry about - since that is the largest insurance company in this area. Wait until 2014 when insurance will be turned upside down or is it 2012 - can't remember.
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Old 10-07-2011, 01:07 PM
 
Location: Gray, TN
2,172 posts, read 4,023,544 times
Reputation: 911
Isn't Cigna the insurance provider for Eastman?
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Old 10-07-2011, 05:23 PM
 
15,861 posts, read 29,153,749 times
Reputation: 19777
Quote:
Originally Posted by rccrain View Post
Isn't Cigna the insurance provider for Eastman?
Yes. Which is why Cigna is indeed a big enough player in this market.

I wonder why Wellmont doesn't do Transplants?
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Old 10-07-2011, 08:41 PM
 
35 posts, read 72,722 times
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Sounds like the loss of Cigna is indeed the reason this happened. From talking to someone who works at MSHA,they confirmed that A LOT of their patients are covered(or were) through Cigna. Apparently they did get dinged by Health and Human Services earlier this year and ALMOST lost their certification then,but that had nothing to do with this decision(so they say).
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Old 10-07-2011, 08:51 PM
 
15,861 posts, read 29,153,749 times
Reputation: 19777
Quote:
Originally Posted by Green Arrow View Post
Sounds like the loss of Cigna is indeed the reason this happened. From talking to someone who works at MSHA,they confirmed that A LOT of their patients are covered(or were) through Cigna. Apparently they did get dinged by Health and Human Services earlier this year and ALMOST lost their certification then,but that had nothing to do with this decision(so they say).
Are you saying that the reason that they are having trouble reaching terms with Cigna is the reason that they are not going to do transplants anymore?
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Old 10-11-2011, 08:56 AM
 
Location: Kingsport, TN
1,697 posts, read 6,203,339 times
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According to my cousin who's actively involved in many area transplants, MSHA's decision was based solely on $$$. They simply didn't have enough patient volume (30-35/year) to make money from transplants.
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Old 10-13-2011, 08:07 AM
 
9,620 posts, read 5,157,402 times
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This is most likely. The dinging by HHS may be infection rate related, and not necessarily tied to a biz decision to discontinue xplants. The Cigna thing is almost exclusively negotiation posturing. Patients tend to get "tied' to certain hospitals via their docs. So, a way to scare patients into pressuring an insurer is for the hospital to put on a public campaign of hand wringing, and we tried, but the insurance company is just not being fair.
Quote:
Originally Posted by kamoshika View Post
According to my cousin who's actively involved in many area transplants, MSHA's decision was based solely on $$$. They simply didn't have enough patient volume (30-35/year) to make money from transplants.
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