Two hospitals under Peoria, Ill.-based OSF HealthCare went out of network with Blue Cross Blue Shield of Illinois Feb. 1. As a result, some patients are postponing surgeries, The News-Gazette reports.
Here are four things to know about the dispute.
1. OSF completed its purchase of two hospitals previously owned by Chicago-based Presence — Presence Covenant Medical Center in Urbana and Presence United Samaritans Medical Center in Danville — Feb. 1.
2. OSF's physician group — which now includes some Urbana and Danville physicians — contracts separately with BCBSI, The News-Gazette reports. However, the newly renamed OSF Heart of Mary Medical Center in Urbana and OSF Sacred Heart Medical Center in Danville remain out of network with BCBSI.
3. Abraham Kocheril, MD, an Urbana cardiologist who now works for OSF's physician group, said one of his patients with BCBSI insurance canceled a heart arrhythmia procedure after losing in-network coverage at the hospitals. Dr. Kocheril added at least one other patient will likely cancel a procedure due to the coverage change.
4. BCBSI said OSF rejected offers to extend rates previously paid at the two hospitals under Presence Health. OSF argues BCBSI has been unwilling to set rates consistent with what it pays similar hospitals, the report states. OSF spokesperson Shelli Dankoff told the publication, "Negotiations continue, and we remain hopeful on reaching a positive resolution."