Minneapolis-based Children's Minnesota went out of network with Eagan-based Blue Cross and Blue Shield of Minnesota July 5.
Here are five things to know.
1. The contract dissolution could affect roughly 66,000 patients across the system's Minneapolis and St. Paul hospitals, 12 primary care clinics, specialty clinics, six rehab facilities and its Minnetonka, Minn.-based surgery center. Affected patients may need to seek care at other facilities to receive in-network prices.
2. Children's initially terminated its contract with BCBSM March 8 over a Medicaid payment rate dispute. The decision was set to take effect July 5. Children's argued BCBSM proposed rates that would spur significant service cuts, while the payer said Children's rate requests were well above other Minnesota health systems, Star Tribune reports.
3. Bob Bonar, CEO of Children's Minnesota, said in a statement to Star Tribune the hospital is "disappointed that Blue Cross has been unwilling to find common ground given the scale and scope of vital pediatric services that we provide in this community."
4. Garrett Black, senior vice president of health services at BCBSM, said the payer offered Children's reimbursement rates above market prices for 2017. He added, "Unfortunately, Children's has instead been focused on an expensive marketing campaign asking patients to pressure Blue Cross into allowing Children's to charge higher prices for their services."
5. Both parities said they are committed to resolve the dispute. In addition, BCBSM approved continued treatment at Children's for more than 4,000 eligible patients, based on clinical criteria provided by Children's.
Editor's note: The BHR e-newsletter on July 5 contained a mistake in reference to this story in its subject line, which stated Boston Children's was out of network with BCBSM. Becker's regrets the error.