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 Miami Litigation Partner Georgia A. Thompson was recognized by South Florida Business & Wealth magazine with a 2023 Up and Comer Award—Excellence in Leadership (Existing Company).
The arrival of new Miami Healthcare Partner Magda Rodriguez was featured in the Florida Bar News' On the Move column.
The arrival of new Miami Healthcare Partner Magda Rodriguez was featured in the Miami Today article, "Day Pitney Adds Partner."
Day Pitney Trusts and Estates Partner Tasha Dickinson and Litigation Partner Mark Romance authored the article, "What Partners Can Learn From Associates: Top Five Insights," for the Daily Business Review.
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The arrival of new Miami Healthcare Partner Magda Rodriguez was featured in CityBiz article, "Magda Rodriguez Joins Day Pitney as a Healthcare Partner in the Firm's Healthcare Life Sciences and Technology Practice."
The arrival of new Miami Healthcare Partner Magda Rodriguez was featured in the Daily Business Review article, "Day Pitney Expands Health Care Practice in Miami as it Prepares to Focus on Palm Beach Growth."
Day Pitney Healthcare practice chair Susan Huntington was featured in the Hartford Business Journal article, "With COVID-19 Emergency Orders Lifted, Employers Seek Guidance on Workplace Precautions."
Day Pitney Counsel Ashley Picker Dubin was featured in the Legaltech News article, "Generative AI May Worsen Access to Justice—At Least in the Short Term."
Florida Partner Gary S. Betensky has been reelected to serve as chair of the Palm Beach County Environmental Control Hearing Board for a third year.
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