A recent decision by Blue Cross and Blue Shield of Illinois could make it more difficult for small hospitals to preserve their independence by affiliating—rather than merging—with larger healthcare systems.
The move came in reaction to a deal struck earlier this year between south suburban Silver Cross Hospital and Advocate Health Care, the largest hospital network in the state.
As part of their affiliation, the systems planned to jointly negotiate reimbursement rates with Chicago-based Blue Cross, the state's dominant insurer. Silver Cross, an independent single hospital based in New Lenox, Ill., would be buoyed by the heft of Advocate, which has 12 hospitals and plans to get even bigger by merging with north suburban powerhouse NorthShore University HealthSystem.
But Blue Cross won't negotiate reimbursement rates with affiliations created by separate health systems that clinically integrate rather than those under common ownership, Dr. Lee Sacks, chief medical officer of Downers Grove-based Advocate, said during a meeting yesterday with the Crain's Chicago Business editorial board.