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We are fighting for our patients’ health: Important news about our contracts with Blue Cross and Blue Shield of North Carolina

Blue Cross is putting our future – and our communities’ health – at risk.

Update: BCBSNC has removed all Mission Health providers from its online directory. This overt and senseless action has created unnecessary confusion for BCBSNC members. All Mission Health providers are in network with BCBSNC until midnight on
October 4, 2017.

Mission Health System is a leading healthcare provider. We are one of the most efficient hospitals in the state, as well as one of the top-quality hospitals in the country. We have been recognized by Truven Health Analytics/IBM Watson Health as a “Top 15 Health Systems” in five of the last six years between 2012-2017.

Maintaining excellent patient care has become more expensive each year, and we know how much it costs. We cannot keep up with rapidly rising medical supply, pharmaceutical, and labor costs without appropriate inflationary adjustments to our rates.

If Blue Cross refuses to engage with us, our contracts will end at midnight on October 4, 2017. If this happens, our hospitals, associated facilities and physicians will be out of network for all Blue Cross members beginning October 5, 2017.

There are no immediate changes for Blue Cross members. Patients can continue to receive care at our facilities and with our physicians without interruption. Blue Cross members’ in-network access will only change if we are unable to reach a new agreement prior to October 5. If this happens, Mission Health System will be removed from Blue Cross’ provider network. Its members will still have access to Mission’s physicians, hospitals and other providers, but under different payment terms. It’s important to know that Blue Cross Medicare supplemental health plans are NOT impacted. Even if we are out of network with Blue Cross, you will still have in-network access to Mission providers. 

Blue Cross Forced This Issue

With 72% of the market in our state, Blue Cross has a history of getting what it wants. It has exercised its power by forcing healthcare providers into “forever” contracts that renew automatically, with zero adjustments to the rates we are paid for providing healthcare services.

At the same time, the actual costs we incur for providing care keep rising – supplies, drugs, wages, everything that goes into quality care.

To renegotiate Blue Cross contracts, a healthcare provider is forced to give notice of “termination.” Blue Cross has demonstrated a pattern of acting aggressively against healthcare providers who give notice of termination in order to intimidate them.

Unless we convince Blue Cross to renegotiate our contracts, we would be facing disastrous financial pressures that could force the closure of many services and programs.

So, we did the only thing we could do. We gave notice of a termination for our forever-zero contracts, and created a deadline for renegotiating new, fair contracts that won’t put our future in jeopardy.

Our prices are 23% lower than similar hospitals in the state, 36% lower than the most expensive hospitals in the state, and 7% lower than local hospitals in western North Carolina. 
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(Source: North Carolina Medical Care Commission Healthcare Cost Database)
Our prices are 23% lower than similar hospitals in the state, 36% lower than the most expensive hospitals in the state, and 7% lower than local hospitals in western North Carolina.

(Source: North Carolina Medical Care Commission Healthcare Cost Database)

Blue Cross has consistently issued year-over-year premium increases to its customers.
Blue Cross has consistently issued year-over-year premium increases to its customers.

Our Ask

Blue Cross has consistently issued year-over-year premium increases to its customers. Yet it has failed to increase what it spends on its members’ healthcare services accordingly. 

We are asking for a modest, single-digit adjustment to Blue Cross’ payment rates as part of a multi-year agreement.

Accepting the rates Blue Cross put in front of us would severely threaten the long-term viability of Mission. No organization of any kind can continually receive less for its services than it costs to provide them. It’s an unfair position to put us and our community in, and Blue Cross knows that.

We are not asking for big increases or to be paid above-market rates. All we are asking is for Blue Cross to work with us toward a balanced contract that puts patient care first.

We wouldn’t be asking for these increases if it wasn’t absolutely necessary for our health system – and Western North Carolina residents who depend on our lifesaving care.

Our Experience to Date

For more than six months, we have tried to engage Blue Cross in meaningful contract discussions. They have continued to say they would work with us but have never followed through. We have even met in-person to seek compromise. Yet Blue Cross hasn’t budged at all.

This left us with no choice but to terminate all our contracts to set a deadline to reach agreement on new contracts that include fair rates for future years.

Our Commitment

We value our long-standing relationship with Blue Cross and we are committed to continuing good-faith negotiations. We want to work cooperatively with Blue Cross to find a solution that works for both our organizations and avoids any disruption to our patients’ ability to access qualtity healthcare services.

We hope that Blue Cross shares this position, and that our common goals drive us to an agreement.

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