Mission Health, BCBS end contract: 5 things to know

Asheville, N.C.-based Mission Health System's contract with Blue Cross and Blue Shield of North Carolina expired following a monthslong feud.

Here are five things to know.

1. Effective Oct. 5, BCBSNC members lost in-network access to nearly all Mission Health physicians and facilities. Most affected patients will have to pay higher, out-of-network rates to receive services.

2. President and CEO of Mission Health Ronald Paulus, MD, said, "Now that Mission Health is out of network with BCBSNC, we will not make any further public comment about the contract situation under any circumstances until such time — if ever — that it is fully resolved." 

3. BCBSNC's CEO Brad Wilson said while "Mission Health is no longer accepting Blue Cross NC insurance, our customers still have hundreds of options for in-network care." BCBSNC added emergency care at Mission Health will continue to be in-network for policyholders.

4. The fight over reimbursement rates surfaced July 5 when Mission Health said it would terminate its contract with BCBSNC. The two sides continued to publicize their disagreements, with Mission Health's board penning an op-ed July 24 claiming BCBSNC forced a "'forever zero' contract, claiming it [couldn't] afford any increase despite dramatically raising premiums to its own customers during each of the last four years." In August, Mr. Wilson countered the claim in a separate op-ed, stating the insurer offered a fair contract comparable to other area hospitals.

5. Casey Hite, CEO of Asheville-based medical equipment provider Aeroflow Healthcare, told Becker's Hospital Review the contract termination "will have a huge impact on patients with Blue Cross Blue Shield North Carolina. While many people in North Carolina will still be able to find alternate care, many will need to travel to get it affordably. Traveling out of state for healthcare will have statewide implications, causing a ripple effect — first impacting the patient's health and well-being, then their family's and then the entire community's well-being and economy. The current uncertainty around the nation's healthcare system may be causing insurance providers to hunker down and protect themselves during this time."

 More articles on payer issues:
Hartford HealthCare, Aetna reach in-network deal
Augusta Health to terminate in-network contract with Anthem
Sanford Health, HealthPartners team up for Medicare plans

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