THIRD MANAGED CARE PROVIDER MAKES ITS PITCH

Cape Girardeau looks lucrative to managed health-care providers. A third company is making a pitch for business here.

Representatives of HealthLink, a managed-care company with customers primarily in Missouri and Illinois, met Tuesday with Cape Girardeau's two hospital administrators, employers and insurance agents.

Last week, Humana announced it was making inquiries in the area about interest in a managed-care insurance product. Two weeks ago, a local physician hospital group called MedAmerica HealthNet announced its insurance product called HealthNet Blue.

While managed care, health maintenance organizations (HMO) and preferred provider organizations (PPO) have been around for years, the ideas are new to Cape Girardeau. Two-thirds of insured workers nationwide have some type of managed care.

Mary Neimeyer, HealthLink marketing representative for Missouri, said her company wants to create managed-care competition in Southeast Missouri. She said several attempts over the past five years to set up a managed care system in Cape Girardeau have been unsuccessful.

Now that the Cape Girardeau area is opening up to managed care, Joe Eschbacher, vice president for marketing with HealthLink, said his company wants to be in picture.

James Wente, administrator at Southeast Missouri Hospital, agreed that interest in managed-care organizations is on the rise.

Over the years, Wente said, a host of managed-care companies have made a pitch to set up business with Southeast. "Not yet have I had any managed-care company that has taken a keen interest in service," he said

The thinks many companies are interested in the bottom line rather than quality health care.

"I do not make bad business decisions based on pressure," he said. "That's what I have felt, particularly in the past two years."

Wente said he and St. Francis Medical Center President John Fidler came up with the idea for MedAmerica HealthNet two years ago. MedAmerica networks five Southeast Missouri hospitals and 220 physicians.

According to Fidler, "Just putting a network together was something no one else could do."

MedAmerica met with eight managed-care companies, including HealthLink. Blue Cross/Blue Shield was chosen to work with the physician hospital organization (PHO).

"Only Blue Cross was interested in a joint venture," said Wente. The others asked for hospitals and doctors to give discounts. "They said, We'll sell it and we'll keep the profit," Wente said. "We said, No."

HealthLink doesn't sell insurance, so it couldn't offer what the PHO was looking for.

At the meeting Tuesday, several insurance agents said their customers are already members of HealthLink and would like to see Cape Girardeau's hospitals participate with that company.

Fidler responded that other products and partnerships are possible in the future, but will take time organize. The HealthNet Blue product is still waiting for final approval from Missouri's Division of Insurance.

Wente said the PHO isn't working exclusively with Blue Cross/Blue Shield. "We are willing to talk with any company," he said.