Blue Cross of Kansas, Salina hospital negotiates with public at heart

Blue Cross of Kansas, Salina hospital negotiates with public at heart

Hospital enters negotiations with the insurance coverage firm

Blue Cross Blue Defend of Kansas and Salina Regional Well being have taken negotiations about aggressive fee charges public, with the hospital claiming the insurance coverage firm was deceptive about charges it paid different programs.

Salina Regional claims the insurance coverage firm paid comparable well being programs within the state as much as 50% larger charges than it paid Salina Regional for a minimum of two years. Blue Cross of Kansas acknowledged the charges Salina Regional is negotiating for are unreasonable and will value members hundreds of {dollars}.

Salina Regional’s CEO Joel Phelps sent a mass email to hospital staff April 27 about in-network entry to Blue Cross of Kansas. The e-mail was in response to a video message from Blue Cross of Kansas about entry, and the healthcare supplier coming into negotiations with the insurance coverage firm.

“(Salina Regional) must be paid pretty, and meaning (Blue Cross of Kansas) making our fee charges equal to different comparable hospitals within the state,” Phelps wrote in an e-mail to employees.

In its video, Blue Cross says Salina Regional is looking for hikes that might include a considerable value to members, and appealed to the general public to contemplate their very own monetary contributions.

“After we pay them more cash, you pay them extra,” mentioned Blue Cross of Kansas CEO Matt All within the video.

Salina Regional mentioned it observed discrepancies in charges of pay when the well being system began evaluating publicly out there information discovered on its competitor’s — Lawrence, Stormont Vail, St. Francis, and Manhattan — web sites. This information is comparatively new after laws were passed in 2021 calling for extra transparency to the general public relating to hospital costs.

Starting July 1, 2022, well being insurers and self-insured employers had been required to publish on web sites itemized costs they negotiated with suppliers for well being care companies. The exception to the legislation is costs paid for pharmaceuticals, besides these administered in hospitals or medical doctors’ places of work.

Consultants believed releasing this information could have an effect on future prices and the way employers contract for healthcare, because it supplies the general public perception on how their insurers are faring in comparison with others. And perception on accurate dollar amounts paid to hospitals by insurance coverage firms.

Blue Cross of Kansas has a minimum of partially complied with the federal mandate, as negotiated fee charges can be found on competing well being system web sites. Blue Cross of Kansas didn’t reply in time for publication about its charges paid to hospital programs corresponding to Salina Regional.

Salina Regional, Blue Cross of Kansas make appeals to the general public in current messaging

Every year, Blue Cross of Kansas sends each hospital and doctor within the state a letter outlining the fee charges for the care they supply the next yr. Suppliers should signal the letter by a given deadline or the contract ends, and so they develop into an out-of-network supplier.

Phelps mentioned Salina Regional has not been proof against monetary pressures hospitals throughout the nation have endured over the previous couple of years. Uncontrollable circumstances just like the pandemic and provide points have pushed up the price of care and hospital prices have risen faster than basic inflation.

Salina Regional argues that Blue Cross of Kansas pays it too little for the service the well being system supplies as prices proceed to rise. In his e-mail to employees, Phelps mentioned Salina Regional may have no alternative however to exit of community if Blue Cross of Kansas doesn’t enhance its fee charges.

“We get it. Nobody needs to pay extra for healthcare,” Phelps mentioned in an e-mail to employees. “We don’t need you or your staff to pay extra both. We all know Blue Cross has the cash with out elevating premiums one penny.”

However Blue Cross of Kansas holds that present calls for from Salina Regional is just not a good ask.

“(Salina Regional) executives are demanding more cash, drastically more cash, past the truthful and cheap charges that we already pay them,” All mentioned in a press release.

What does this imply for Blue Cross of Kansas members?

Whereas each side of those negotiations declare to characterize sufferers’ greatest pursuits, the outcomes of them have traditionally left sufferers navigating the monetary stakes that end result, like restricted entry and affordability.

The continuing rigidity between insurance coverage firms and healthcare suppliers is just not restricted to Kansas and stretches throughout the nation. But it surely typically stays out of public purview until they become patients within the nation’s difficult well being system.

The battle between Salina Regional and Blue Cross of Kansas has already thrust the general public, members of Blue Cross of Kansas, into the middle of the controversy in its early levels. The significance of high-quality medical care near dwelling, and general affordability of take care of members, is leveraged by each events.

Blue Cross of Kansas had a similar negotiation dispute with Lawrence Memorial Hospital in 2021, after a suppose tank that research hospital insurance coverage claims discovered massive well being plans acquired a greater deal at Lincoln Memorial than the nationwide common.

Regardless of rising tensions, each events acknowledged that they wish to come to an settlement that’s mutually helpful. As negotiations proceed, members can nonetheless obtain Blue Cross in-network care at Salina Regional. The present contract between Blue Cross of Kansas and Salina Regional ends this yr on Dec. 31.

This can be a creating story. The Salina Journal will present updates as negotiations proceed and extra info, together with varied charges supplied to competing hospitals, comes out there.

Kendrick Calfee has been a reporter with the Salina Journal since 2022, primarily protecting county authorities and training. You may attain him at [email protected] or on Twitter @calfee_kc.

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