Michael Furey was quoted in an article, "An inside look at how Horizon used hospital costs – and quality – in plan to change N.J. health care," which was published on NJ.com and also appeared in the July 29 edition of The Star-Ledger under the headline, "Reports: Horizon Skewed Quality, Costs on New Plan." The article focuses on confidential reports and related documents obtained by Advance Local Media, publisher of The Star-Ledger, in connection with a lawsuit brought by three New Jersey-based hospitals alleging Horizon Blue Cross Blue Shield of New Jersey breached its obligations by limiting its selection of Tier 1 hospitals to the largest hospital systems. The materials, prepared by McKinsey & Company, were developed to help Horizon establish a new line of insurance products called OMNIA, which launched in November 2015. According to the article, the three hospitals involved in the ongoing litigation—CentraState Medical Center, Holy Name Medical Center and Valley Hospital—are losing millions of dollars a year and are at risk of having to cut services or merge to stay afloat.
The article reports that McKinsey had initially recommended hospitals other than the large systems be Horizon's partner hospitals because they provided excellent care at average or less than average cost. The plaintiff hospitals were in this group, according to the report. Horizon, however, rejected the recommendation and requested McKinsey not consider a hospital's cost of care in making recommendations. Horizon claimed, according to the report, that the cost of care would be irrelevant to the value based care plan Horizon wanted to introduce. The plaintiff hospitals argue such reasoning allowed Horizon to pick the largest and most expensive hospitals as its OMNIA Alliance and Tier 1 partners, which had always been Horizon's plan. The Tier 2 hospitals tend to be smaller and less expensive.
Furey, who represents the three plaintiff hospitals, told The Star-Ledger it has been three years since OMNIA made its debut, and yet it appears hospitals are still paid the same old way. He questioned, when does the value pricing begin?
Day Pitney Litigation Partner Stephen Catanzaro and Litigation Associate Erin Hodgson authored the article "Appellate Division Rejects Objectors' Attempt to Challenge Development Approvals," for the New Jersey Law Journal.
Day Pitney Healthcare Attorneys Susan R. Huntington and Phoebe Roth authored the chapter titled "Using Enterprise Risk Management-Based Frameworks to Advance Population Health" for American Health Law Association (AHLA) and the American Society for Health Care Risk Management's (ASHRM) book titled "Enterprise Risk Management for Health Care."
Day Pitney Florida Offices Managing Partner Manuel Garcia-Linares has been appointed to chair the firm's Litigation department. The news was featured in Miami Today.
Day Pitney's Executive Committee, Executive Board and department leadership changes were featured on CityBiz.
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Day Pitney's Executive Committee, Executive Board and department leadership changes were featured in Law360 Pulse.
Day Pitney Litigation Partner Georgia Thompson was featured in the Daily Business Review article on the Florida Legal Awards' On The Rise Honorees.
Day Pitney Healthcare, Life Sciences, and Technology Counsel Damian Privitera's arrival was featured in the Law360 article "Moses & Singer Healthcare Atty Joins Day Pitney in Hartford."
Day Pitney Partners Stephen Catanzaro, Laurence Smith, and Elizabeth Yoo were featured in New Jersey Law Journal's 2024 New Partners Yearbook, which highlights partners, including lateral partners, made or hired at New Jersey firms.
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