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Mission-BCBSNC still not negotiating as contract termination looms Oct. 5
Thursday, 05 October 2017 11:08

260K WNC customers with Blue Crosscould be socked with higher health care costs

From Staff Reports 

Mission Health and Blue Cross Blue Shield of North Carolina still were not talking to one another over their contract dispute, as of the Daily Planet’s Sept. 28 press deadline.

With no negotiations, no rapid resolution can be realized, which would leave, as of Oct. 5, nearly 260,000 BCBSNC customers in Western North Carolina facing steeper “out of network” charges — that is, if they get care through Mission hospital, its doctors or any Mission-owned health-care facility.

The contract expires between Mission and Blue Cross expires Oct. 5.

Even if the two sides were able to reach a new agreement in the last week of September, there would not be enough time to implement it before the existing one expires, a Blue Cross official told the Asheville Citizen-Times on Sept. 23.

“We know for a fact that Mission will be out of network on Oct. 5,” Mark Newman, vice president of Blue Cross’ network management, told the AC-T, adding that implementing a new agreement would take several weeks.

Mission, which is the largest private employer in the state west of Charlotte, and BCBSNC dominate in WNC in, respectively, providing health care and health care insurance coverage.

Mission owns seven hospitals in the region and employes 12,000 workers, including 20 percent of the region’s physicians.

Blue Cross is the state’s largest private insurer and it provides coverage to about 70 percent of those with nongovernmental policies. 

Both sides have said they are willing to restart discussions on Oct. 5.“

After Oct. 5, we’re ready to resume negotiations... It’ll be a clean slate,” Newsome told the AC-T.

Meanwhile, Ron Paulus, Mission’s chief executive officer, wrote in a guest column in the AC-T on Sept. 3:

“How much is enough?

“A barrage of negative advertising and misleading claims from Blue Cross and Blue Shield of North Carolina have generated a common question: ‘How much is enough?’ Since reporting more than half a billion dollars of profit ($542 million) for the first six months of 2017 — that important question has new and very profound meaning.

“Let’s put BCBSNC’s extraordinary profits into context: it would take Mission more than 15 years to earn what BCBSNC did in just six months. If Mission accepted BCBSNCs below zero or “forever zero” contract offers, we would be devastated — slowly, but surely over the coming years.

“But with just over 3 percent of its last six months’ profit, BCBSNC could cover Mission’s requested paymentincrease and support quality health care for our 1 million residents — and not rate increase for any consumer or employer; alternatively, it could use that profit to cover Mission’s requested payment increase for more than 25 years.“My repeated requests to even discuss a contract have always been immediately rejected....” Paulus wrote.

Later in the column, the CEO noted, “Everyone in Western North Carolina — not ust BCBSNC’s customers — needs Mission and BCBSNC to work together. Mission needs your support to ask BCBSNC to break its nonsensical vow of silence, focus on the people of WNC and talk to Mission about a contract. As long as the issue remains BCBSNC’s profit, control and power, we all lose; but if we focus on improving health and managing costs effectively together, we all win.

“We can only hope BCBSNC’s board — and its new CEO who begins Oct. 1— know how much really is enough,” Paulus concluded.



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