Without Agreement, Albany Med Health System Warns It May Drop CDPHP

• No final decision, but patient notification required
• No resolution for nearly $50 million insurance company owes hospital
• Health system sustainability critical; scope of services at risk

Without an acceptable agreement after months of negotiations, the Albany Med Health System may be forced to remove CDPHP as an accepted insurance plan in 2025. At issue is as much as $50 million in payments CDPHP has withheld from Albany Medical Center for care provided to the insurance company’s members this year. Additional shortcomings are projected to impact the System’s Columbia Memorial, Glens Falls, and Saratoga hospitals next year. While no final decision has yet been made, the System is required to inform CDPHP members of the possibility that services provided by these hospitals may be out-of-network in 2025. CDPHP members who seek care through the Albany Med Health System are receiving this letter explaining the situation and their options.

“It is particularly difficult to observe CDPHP knowingly violate its commitment to our hospitals and the patients we serve in a way no other insurance company has,” said Albany Med Health System President and CEO Dennis P. McKenna, MD. “The termination of a contract with any insurance company is always a last resort—especially one we have worked with for years. We must consider our long-term viability for the patients who rely on our care.”

CDPHP has failed to fully reimburse Albany Medical Center on nearly 26,000 claims since August by an average of up to $2 million per week. Approximately $8 million in additional obligations have been withheld or unpaid since January. The payments reflect care already provided to CDPHP members. That funding is significant, and it is reinvested directly into patient care services. Furthermore, CDPHP’s 2025 contract proposal does not cover the cost of caring for its own members. This presents a significant challenge to the System’s overall mission.

“If a resolution with CDPHP is not reached, we may also be in the unfortunate position to reduce the number of services we provide,” Dr. McKenna said. “While we remain hopeful an agreement is reached, we must take the necessary steps to ensure patients are informed and access to the most critical care is preserved. As the region’s only truly local health system, we strongly value our longstanding relationship with patients. We have to do everything we can to maintain the services they need most.”

The Albany Med Health System will continue to communicate with patients as negotiations continue. Colleagues who participate in the Albany Med Health System’s employee medical plans will remain covered by each hospital.