Nashville, Tenn.-based Vanderbilt University Medical Center and BlueCross BlueShield of Tennessee are at a stalemate over negotiations for the 2016 Medicare Advantage network, according to The Tennessean.
Both VUMC and BCBS of Tennessee have sent letters to Medicare Advantage enrollees in recent weeks, warning that they might have to switch insurers to continue seeing Vanderbilt physicians, or switch physicians to remain covered by the same insurer. The letters cite a disagreement over rates for 2016.
Vanderbilt said it is "troubled by this decision by BlueCross to terminate our contract" in its letter, according to the report.
The letter, signed by VUMC CMO Paul Stemberg, MD, stated the health system is "not currently negotiating or seeking any additional rate increases for next year. BlueCross required, on short notice... that VUMC accept a significant payment reduction or they would notify our patients of this termination. We cannot provide the services you expect at the reduced levels of support BlueCross has proposed."
"There are cost pressures in the Medicare system. We're sensitive to that," said Roy Vaughn, vice president of corporate communications of BCBST. He said the rates the insurer offered to VUMC fall within a range set by Medicare. "We want to be able to provide a product where we can compete and provide affordable rates. It may be that we may not be able to reach an agreement."
In fiscal year 2014, Medicare accounted for 29.5 percent of VUMC's gross revenue, according to the report.