Mountain States Health Alliance, BlueCross BlueShield of Tennessee still at odds
The region's largest healthcare company and Tennessee's largest insurance company are still at odds.
So far it seems the two sides have only agreed to one thing, and that's last month's decision to extend contract negotiations by 30 days.
Mountain States Health Alliance’s contract with BlueCross BlueShield of Tennessee is now set to expire June 30. “Unfortunately we are still quite a ways apart,” says Mountain States Health Alliance Vice President Tony Benton.
We're told the two sides meet regularly, but the divide is growing. “There has been a lot of back and forth. That’s part of the process. We are working hard to reach an agreement; we understand people want to see us reach an agreement,” says Roy Vaughn, Vice President of Communications for BlueCross BlueShield of Tennessee.
It boils down to money. Facing major federal funding cuts over the next decade, Mountain States wants to be paid more for its services. “We would like to have an inflation adjustor. The cost of living continues to go up, labor needs raises, those types of things in the economy. We want to find a way to do that. Would we be willing to accept the current prices? I’m not in a position to answer that,” says Benton.
Blue Cross Blue Shield wants to pay less than it does now. News 5 WCYB found out the insurance company’s most recent offer reduces reimbursements lower than the first offer. “This is about rates -- from our prospective as a statewide health plan, we know Mountain States is reimbursed at rates higher than other providers in the region,” says Vaughn.
BlueCross BlueShield of Tennessee is coming off of its best financial year ever in 2012. Reports out this week show the non-profit insurance giant earned record profits of more than $221 million in 2012.
It’s not uncommon for healthcare companies and insurance companies to negotiate contracts, but officials say what is uncommon for them to play out in public. “BlueCross sent out communication to patients; we felt we needed to respond as well,” says Benton.
Mountain States has since mailed over 10,000 letters to the community asking for response about staying in the BlueCross BlueShield network; officials say roughly 200 people have responded.
BlueCross BlueShield is one of the largest insurance providers for Mountain States patients, but with no end in sight for the contract dispute, hospital officials say those patients may soon have to shop around. “People have options, and they may have to look at those options,” said Benton.
BlueCross BlueShield of Tennessee responded by saying there are thousands of in-network providers creating options on both sides of the equation.
Both companies say they hope to reach an agreement. The two sides are meeting face to face every couple of weeks.
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