Health insurers, to reduce the high cost of health care for members, use provider networks to deliver savings. Health insurers actively negotiate provider network contracts, and at times, terminate contracts with providers who they believe are paid more than their colleagues.
Blue Cross Blue Shield Plans have been involved in a number of network contracts during the last quarter of 2022, including:
The University of Mississippi Medical Center (UMMC) and Blue Cross & Blue Shield of Mississippi (Blue Cross) reached an agreement. Effective December 15, 2022, all UMMC facilities, physicians and other individual Professional Providers are fully participating Network Providers for all Blue Cross commercial health plans, including the Federal Employee Plan and Blue Cross and Blue Shield Plans from other states.
Hendrick Health has been working with Blue Cross Blue Shield of Texas (BCBSTX) in good faith to negotiate a new contract for Hendrick Medical Center and Hendrick Medical Center South services in Abilene, and Hendrick Clinic and Hendrick Anesthesia Network providers in Abilene and Brownwood. The contract is scheduled to end Feb. 1, 2023.
Highmark BCBSWNY, Catholic Health, and Catholic Medical Partners announced a new long-term contract agreement. This will ensure Highmark BCBSWNY members will have continued access to care at Catholic Health hospitals and its comprehensive network of services. As one of the largest health systems in Western New York, Catholic Health serves thousands of patients across its network of hospitals, subacute care facilities, primary care centers, home care agencies, and diagnostic & treatment centers. Its hospital network includes Kenmore Mercy Hospital, Mercy Hospital of Buffalo, Mount St. Mary’s Hospital, and Sisters of Charity Hospital and its St. Joseph Campus.
Blue Cross and Blue Shield of Vermont said it would forego a contract with OneCare Vermont for 2023 due to the lack of tangible quality outcomes, inability to reduce costs and what it feels is a “new data approach” that introduces concerns about security and privacy.
Blue Cross Blue Shield of Illinois ended a 30-year relationship with Springfield Clinic’s 650 providers that break up left at least 55,000 patients without their doctors or with staggering bills. As a result, the clinic is launching its own health plan.
Southwestern Health Resources and Blue Cross and Blue Shield of Texas recently reached a new contract agreement . The deal means there won’t be an interruption in coverage for people who are insured by Blue Cross and get treatment through one of the largest healthcare systems in Texas.
Takeaway: Control of provider networks continues to be a source of friction between health insurers and providers