UM wins $21 million contract with Blue Cross

September 07, 1995|By John Fairhall | John Fairhall,Sun Staff Writer

University of Maryland Medical Center has won a $21 million contract to be the exclusive source of cardiac care for 200,000 HMO subscribers of Blue Cross and Blue Shield of Maryland.

Blue Cross invited contract proposals from several other hospital centers -- including Johns Hopkins, St. Joseph, Sinai and Union Memorial -- but "we decided the university had the best total package," said Dr. Robert N. Sheff, Blue Cross senior vice president for medical affairs and quality management.

Announcing the three-year contract yesterday, Blue Cross and university officials asserted that it is a unique agreement in the field of cardiac care in Maryland.

A new University of Maryland Cardiology Network brings together 34 doctors in communities around Maryland, 17 members of the university's medical faculty, six heart surgeons and other doctors. They will work as a team, in effect, sharing responsibility for the cost and quality of care for subscribers of the FreeState, CareFirst, Potomac Health and Delmarva HMOs.

Patients will be referred by their family doctor to community cardiologists or, if more specialized care is needed, university doctors. All heart surgery and angioplasty, a procedure to open blocked arteries, will be performed at the university medical center in Baltimore. Emergency cases will continue to be treated at the nearest local hospital.

Dr. Sheff said patients will benefit from "increased coordination of their care, increased continuity of their care."

Blue Cross benefits by obtaining what its officials say will be the best-quality care for subscribers at the lowest possible price. The university gains a large and potentially lucrative source of patients.

Blue Cross will pay a university organization, University Physicians Inc., a set amount of money to meet all the cardiac care needs of its HMO subscribers, including hospitalization. This organization, which contracts with managed-care organizations like Blue Cross, profits if it holds down costs.

Dr. Andrew A. Ziskind, medical director of the cardiology network, said the arrangement will stimulate investment in prevention and discourage overuse of expensive diagnostic procedures.

Doctors also will be able to "improve what we do" by collecting data on a large number of patients and examining what works and what doesn't, Dr. Ziskind said.

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