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of Utah Medical Center (UMC) or Davis Hospital and Medical
Center. In particular, Health Services entered into special
contracts with UMC to obtain services from UMC’s: (1)
Intermountain Burn Center (the only certified burn center in the
region); (2) Neuropsychiatric Institute (to provide psychiatric
beds when LDS Hospital temporarily exceeded its inpatient
capacity); and (3) Pain Management Center. Some UMC admissions
were related to a unique relationship between Primary Children’s
Hospital, a Health Services hospital dedicated to acute care
pediatric services, and UMC’s specialized genetic research and
other pediatric-related teaching and research programs. In
addition, Health Plans, petitioner, and Care entered into
provider agreements with Davis Hospital and Medical Center,
located in Davis County, Utah, because there were no Health
Services hospitals in the immediate area.
During the 2-year period including 1997 and 1998, UMC
accounted for approximately 50 percent of all inpatient hospital
services provided to petitioner’s enrollees by independent Utah
hospitals. During the 2-year period including 1997 and 1998, UMC
accounted for approximately 42 percent of all outpatient hospital
services provided to petitioner’s enrollees by independent Utah
hospitals.
Petitioner maintained a Core Wellness Program under which
SelectMed enrollees were provided health care information and a
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