Blue Cross and Blue Shield of Montana has formed a managed-care health plan with a multispecialty clinic in Great Falls, Mont., on the heels of the July 1 merger of the city's only two acute-care hospitals.
Under a 50-50 joint venture agreement, the Helena, Mont.-based Blues organization will manage the plan and assume risk, while Great Falls Clinic, a group of about 100 physicians, will provide enrollees with clinical services.
The Montana Blues currently provides healthcare coverage for more than 235,000 people in the state through traditional and managed-care benefit plans and administrative services agreements. It also operates a statewide HMO, called HMO Montana.
The joint-venture plan, called MontanaCare, is scheduled to be rolled out in January. It will offer group and individual managed-care policies as well as some point-of-service products.
This summer, 339-bed Montana Deaconess Medical Center and 145-bed Columbus Hospital, both in Great Falls, completed their merger after much scrutiny from federal regulators. The Federal Trade Commission approved the deal after the hospitals agreed to certain conditions, including a limit on profits and a requirement to pass back at least $86 million in cost savings to consumers (July 8, p. 5). The merged entity has since been renamed Benefis Health Care.
Tanya Ask, a spokeswoman for the Montana Blues, said the formation of MontanaCare was not related to the hospital merger. She said the new health plan views Benefis as a potential partner rather than a competitor. MontanaCare, she said, is interested in contracting to use the company's facilities to provide hospital services for its enrollees. "We're not competing with them at all," she said.
Lloyd Smith, president and chief executive officer of Benefis, said the company is in discussions with MontanaCare regarding a relationship. He said Benefis is considering a range of partnerships with MontanaCare, including a financial stakeholder role and that of a contractual provider.
"We don't see MontanaCare necessarily in a competitive framework," he said. "We see it as a development in a marketplace that is preparing for managed care. Our interest is to explore with the clinic and the Blues how we can best interact with that development."