Mission Health board inks op-ed on BCBS feud: 5 things to know

Asheville, N.C.-based Mission Health System representatives penned an op-ed stating a "fair contract" with the state's largest insurer — Durham-based Blue Cross and Blue Shield of North Carolina — "is not a want, it is an absolute need."

Here are five takeaways from the op-ed, published in Mountain Xpress July 24.

1. Earlier this month, Mission Health said it plans to leave BCBSNC's network by Oct. 5.  In the op-ed, board members wrote Mission Health worked collaboratively with BCBSNC to negotiate rates in the past. Six months ago, Mission Health requested a "modest, mid-single digit reimbursement increase," expecting mutual negotiations.

2. However, the nonprofit health system said BCBSNC denied the request, "forcing a 'forever zero' contract, claiming it can't afford any increase despite dramatically raising premiums to its own customers during each of the last four years."

3. In a July 6 blog post, BCBSNC argued "Mission Health is among the most expensive facilities for common inpatient procedures such as deliveries, knee replacements and imaging procedures like chest x-rays and CT scan," and the contract termination is happening due to Mission Health's requested fee hikes. Mission Health representatives refuted the argument in their op-ed, stating Mission's rates rest 23 percent below similar North Carolina hospitals and 7 percent below local hospitals.

4. While increases in supply costs and decreasing government reimbursement affect the safety-net system's bottom line, board members added "Mission relies disproportionately on payments from BCBSNC — which controls whether Mission is in the red or black."

5. In a July 5 news release announcing the split, Mark Werner, vice president of provider network at BCBSNC, said, "We are disappointed that Mission Health chose to cancel its contract with us rather than work toward a solution to keep healthcare and health insurance as affordable as possible for our customers in western North Carolina."  

More articles on payer issues:
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4 health systems on the brink of dropping payers

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