Contract between hospitals and Blue Cross/Blue Shield close to expiring
By: Health Insurance
Submitted: 2009-12-15 10:08:07 | Word Count: 474
Manatee County Blue Cross/Blue Shield clients may not have their insurance accepted at Manatee Memorial Hospital or Lakewood Ranch Medical Center. The contract between the hospitals and the insurance company expires at the end of the month.
It's a scary situation for the 23,000 people in Manatee County who have that insurance. Negotiations are still going on. Blue Cross/Blue Shield and the hospitals have been talking since April with no success, and the January 1st deadline is fast approaching.
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Manatee Memorial Hospital and Lakewood Ranch Medical Center provide services you can't find any where else in Manatee County. "We're the only hospital that offers acute care hospital behavioral services, that offers pediatric services, that offers OB service, that offers neo-natal intensive care service. We're the only hospital that has the emergency services that we have," says Moody Chisholm, CEO of Manatee Health Systems.
But unless an agreement is reached, people with Blue Cross/Blue Shield insurance will have to go to another hospital after the first of the year. "Any PPO patients we will take care of. Any HMO patients we will assess. If it's an emergency situation, we'll take care of it here. If it's not, we'll have to transfer them to an appropriate facility," says Chisholm.
Chisholm says the sticking point is the hospital is asking Blue Cross/Blue Shield for a slight increase in fees. "We're not a greedy hospital. We are making an average rate increase request. We need that to be able to maintain the services in this community that we have a reputation for providing."
But Blue Cross/Blue Shield vice president Dr. Barry Schwartz issued this statement: "We must balance the value provided by the hospital against the absolute need to provide affordable health coverage to our members."
Chisholm says the increase they're asking for is less than 10%.
But Blue Cross says: "The demands of Manatee hospitals and health systems are inconsistent with network arrangements for comparable hospitals in the state."
Chisholm says costs at Manatee Memorial have skyrocketed with the bad economy. They're seeing a big increase in the number of indigent, Medicaid and charity cases, and operating costs for medicine and equipment are also going up. He hopes the partnership with Blue Cross/Blue Shield can continue.
Blue Cross/Blue Shield still has a contract for patients at Blake Medical center in West Bradenton, and Doctor's hospital in Sarasota.
