Two major players in the Lehigh Valley’s health care are in court battling a case that could impact patients in Warren County. Coordinated Health sought and was granted an injunction stopping St. Luke’s University Health Network from barring eight Coordinated Health surgeons from performing operations at St. Luke’s Hospital in Phillipsburg.
The eight physicians in question — seven orthopedic surgeons and one general surgeon — work for Coordinated Health through service agreements. They all also hold “staff privileges” to the St. Luke’s-Warren campus, one of two hospitals in Warren County.
Those privileges allow the physicians to treat their patients at St. Luke’s, and two of the physicians held that privilege for 30 years, according to a civil complaint. “This is a fairly common practice among all hospitals in the Lehigh Valley,” Brown said. Importantly, those privileges are required so Coordinated Health’s physicians could remain in-network with Horizon Blue Cross Blue Shield.
Coordinated Health claims that St. Luke’s is closing itself off to physicians who not already affiliated with the hospital, and that St. Luke’s — a not-for-profit health care system — is doing it for money.
Coordinated Health says St. Luke’s is trying to eliminate competition and could potentially force patients to choose between their physician, or their hospital and insurance. St. Luke’s, however, says it is trying to better monitor the quality of its facilities, and that Coordinated Health’s “for profit” system doesn’t work with St. Luke’s nonprofit operation.
Samuel Kennedy, a spokesman for St. Luke’s, provided a statement outlining the hospital’s rationale for barring the Coordinated Health surgeons:
“The surgeons who have brought this action sold their practices to, and have become employed by, a local ‘for profit’ hospital system, which has a different business model and requires that their cases be performed within those facilities,” Kennedy said. “As a not-for-profit healthcare system, our goals many times differ from these types of ‘for profit’ entities. For example, St. Luke’s accepts patients regardless of their ability to pay for our services.
“In addition, many of these surgeons have not performed procedures at St. Luke’s Warren Hospital following their employment by the ‘for profit’ entity. Others have limited their surgical volumes at St. Luke’s Warren Hospital to less than one surgery per month. When surgeons perform surgeries so infrequently at our facilities, it makes it difficult for St. Luke’s to monitor their quality and outcomes. It also creates scheduling problems and hardships in using our electronic medical records correctly.”
The injunction was granted in Warren County court, meaning there will be no changes for the hospital, doctors or patients yet. Kennedy said St. Luke’s “expects to prevail..based on overwhelming case law supporting its position” when the civil process continues next month. Florence Brown, a spokeswoman for Allentown-based Coordinated Health, said a lawsuit would continue. Preliminary hearings are scheduled in March.