MATTOON -- Sarah Bush Lincoln Health Center will stop accepting insurance from the Health Alliance Medical Plan next year.

SBLHC officials said the decision was based on data they said showed that the Carle Foundation Hospital-owned insurance plan was leading more patients to leave the immediate area for medical services.

"The No. 1 reason hospitals own insurance companies is to steer patients to them," SBLHC Vice President of Operations Dennis Pluard said.

In response, Health Alliance Chief Executive Officer John Snyder said "there may be" some increase in patients traveling to Carle facilities, perhaps in Urbana or others in Champaign County, where Carle is based. But it's by choice, not because of insurance coverage, he said.

SBLHC's announcement said it would stop accepting Health Alliance on June 30 and no longer accept the company's Medicare Advantage insurance at the end of next year.

According to Snyder, Health Alliance patients will still be covered for care at the SBLHC emergency room.

Pluard said 12 percent of area patients went outside Coles County for treatment at Carle facilities when SBLHC began accepting Health Alliance in 2011.

Since then, it's increased to 20 percent, he said, explaining that the statistics were from the Illinois Hospital Association's tracking of medical admissions.

When SBLHC started accepting Health Alliance, the thought was patients would use Carle facilities for more complex procedures and services "beyond what Sarah Bush Lincoln was providing," Pluard said.

Patients leaving the area for services SBLHC can provide reduce the income the hospital uses to cover the expenses of treating uninsured and under-insured patients, he added.

Snyder also mentioned services Carle provides that SBLHC does not. Those include Carle's trauma center designation, its neonatal intensive care unit and its heart and vascular unit, according to information from Carle.

It's up to patients to decide where they want to receive medical care and that's "not being directed" by their insurance coverage, Snyder said.

"We would prefer to have the ability to have patients make that choice," he said. "Unfortunately, this takes that away."

Pluard said he understands the "negative impact" of the decision but he's heard some people say they'll change their insurance plans. He added that he hopes those with employer coverage will encourage them to change as well.

"People do not like to change their insurance company but we are hoping people will want to use the local hospital," Pluard said.

Snyder said Carle is "committed" to the Coles County area and noted that Health Alliance patients will still be covered for services at Carle's area clinics.


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