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Mission Health, Blue Cross sign new pact after impasse
Tuesday, 02 January 2018 11:41

From Staff Reports

Mission Health and Blue Cross Blue Shield of North Carolina announced on Dec. 6 that they had reached an agreement.

The deal went into effect Dec. 15, ending a six-month dispute, Mission having publicly announced its intent to sever relations with BCBSNC in July if better contract terms could not be reached.

The standoff led to the termination of a contract that affected an estimated 260,000 people in Western North Carolina.

Effective Oct. 5, those insured by BCBSNC became out-of-network at Mission’s facilities. Mission operates six hospitals, CarePartners, Asheville Specialty Hospital, and several specialty practices. It runs the only Level II trauma center in the region.

Mission claimed it wanted a plan that rewarded it more for patient outcomes than the number of treatments administered.

Representatives of the hospital system had referred to the terms of Blue Cross’ contract  offer as “forever zero,” claiming it offered the hospital no additional compensation in light of rising costs of medicine and a desire to keep up with the latest in technology while recruiting and retaining top talent.

Conversely, BCBS said it was offering Mission the same deal other hospitals across the state had accepted. 

As a result of the standoff, those carrying BCBS insurance had to pay out-of-network costs at Mission facilities. Those affected had the option of changing to another provider, such as UnitedHealth, or seeking help from a doctor unaffiliated with Mission, which, in Buncombe County, are few and far between. 

Those requiring emergency services or receiving qualified ongoing services were still considered in-network.

 Details of the agreement are confidential. Both organizations are referring persons with questions about covering treatments during the two-month outage to their FAQ webpages. 

The agreement was reached as the enrollment period  or the Affordable Care Act drew to an end.

The Center for Medicare and Medicaid Services cut the enrollment period in half, running it from Nov. 1 to Dec. 15, “to more closely align with Medicare and the private market. The program’s advertising budget was also cut to 10 percent of its former allotment.


 



 


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