New York's largest confederation of Catholic healthcare providers is road-testing a home-grown integrated delivery network with employees. Network leaders plan to patch up potholes before signing up local employer groups.
Healthcare systems around the country haven't exactly impressed employers with their prowess at managing healthcare benefits.
In fact, many provider-owned HMOs have lost big bucks. It's one reason New York's Catholic Health Care Network, which operates 17 hospitals, and Servitas IPA, an independent practice association affiliated with CHCN's facilities and representing 1,200 doctors, are taking baby steps with their network, called Benefice Health. Benefice became the self-funding option for employees of CHCN facilities on Jan. 1.
"This is a great lab," said Patrick Aberle, an ex-Sutter Health executive hired to oversee Benefice. Not surprisingly, some glitches already have emerged, with late-arriving identification cards being an example. "I want at least six months to nine months to work out the wrinkles before we bring in a lot of enrollment from the outside."
Until a few months ago, Aberle had been senior vice president of managed care at Sacramento, Calif.-based Sutter. His responsibilities included oversight of Omni Healthcare, a troubled HMO owned jointly by Sutter and Stockton, Calif.-based St. Joseph Medical Center (Aug. 31, 1998, p. 6).
Despite Omni's troubles, Aberle is considered up for the task, according to a healthcare consultant in the Sacramento market.
Still, New York employers question whether providers are ready to make the leap into managed care.
"They question whether providers can handle the administration (of health insurance benefits)," including enrollment, billing and eligibility, said Laurel Pickering, executive director of the New York Business Group on Health.
"I'm just not sure that many of these organizations yet are as fully refined (administratively) as they should be," said Richard Sinni, group healthcare practice leader for the New York metropolitan area of Watson Wyatt Worldwide.
Aberle said he knows employers are skeptical, and he hopes to develop a track record with Catholic facility employees and accumulate data proving that Benefice can control utilization and costs.
Some 7,000 CHCN employees have enrolled in Benefice. But Aberle also must persuade employees of the Roman Catholic Archdiocese, a CHCN co-sponsor, to make the switch. Although the archdiocese considered offering Benefice to its 10,000 employees last fall, it held off because of concerns over the network's breadth of coverage compared with, say, Empire Blue Cross and Blue Shield.
"We've had conversations inside of the archdiocese about the limitation of the Benefice network and how it would be offered," Aberle said. "Those questions are surfacing, and we're answering them as they surface," he said.