New fault lines have erupted in the proposed partnership of Independence Blue Cross and Graduate Health System in Philadelphia as well as in the integrated delivery system the insurer is trying to build.
Last week, MODERN HEALTHCARE learned that Presbyterian Medical Center of Philadelphia, which planned to join Independence Blue Cross' delivery network (July 4, p. 14), is negotiating with the Hospital of the University of Pennsylvania about a possible joint venture.
Presbyterian's board won't reach a final decision on whether to proceed with the Independence Blue Cross partnership until it examines all its options, said Catherine Ruck, a spokeswoman for the 344-bed teaching hospital.
Meanwhile, Graduate is entertaining four other offers, said Harold Cramer, the system's chairman and chief executive officer. He refused to identify the new suitors, adding that Independence Blue Cross' offer remains among the options being weighed.
Initially, Graduate and Independence Blue Cross said they would merge their for-profit operations into a new subsidiary (Feb. 7, p. 8). The subsidiary would link the insurer's four managed-care plans with Graduate's 75,000-enrollee HMO, Greater Atlantic Health Service, and other for-profit subsidiaries. Sources, who have declined to be identified, have speculated that there may be other parties interested in acquiring Graduate's HMO.
In addition, the plan called for Graduate to move its seven not-for-profit hospitals into an integrated network being formed by Independence Blue Cross.
Mr. Cramer, who said he hopes to make a decision by the first week of December, said he'll recommend that Graduate's board pursue a partnership with whoever has "the best chance of offering an integrated delivery system in this market."
Asked about Columbia/HCA Healthcare Corp.'s potential involvement, Mr. Cramer said he's spoken with Richard Scott, president and CEO of the Louisville, Ky.-based hospital chain, regarding joint-venture opportunities. But those discussions have nothing to do with the development of a delivery system, he said.
G. Fred DiBona Jr., president and CEO of Independence Blue Cross, continues to meet with other potential network partners, and those meetings have been more frequent in recent weeks, said Dick Doran, a spokesman for the insurer, which serves 2.3 million people.
"The Graduate deal was the opening for any number of negotiations," Mr. Doran said. "It is still Independence Blue Cross' intention to become involved in the development of an integrated delivery system in the area."