Despite the expiration of their contract with Blue Cross Blue Shield of Mississippi, 10 Mississippi hospitals will continue to charge Blue Cross Blue Shield patients the rates named in the contract, the Mississippi Business Journal reports.
The patients who will be retained by the hospitals account for 30 to 40 percent of the hospitals' insured patients; however, they will be retained at the reimbursement rate that led Health Management Associates (HMA), the owner of the hospitals, to sue Blue Cross for $13 million over the summer, according to the Journal. In the suit, HMA claimed the insurer made unapproved changes to the contract, FierceHealthCare originally reported.
Kace Ragan, HMA's Mississippi spokeswoman, told the Journal that the hospitals would maintain the in-network rates for BCBS patients for as long as they could. While care levels would remain the same, she said, cutbacks in services remained a possibility. The hospitals also would have to plan for the possibility of reduced patient volume. "If we had fewer patients coming to our hospitals, would we consider downsizing? Absolutely," she told the Journal. "That's just business."
Franklin, Tenn.-based Community Health Systems is planning to acquire HMA's 10 Mississippi locations, as well as 61 others, for $7.6 billion, but Ragan said there was no reason to believe the expiration of the BCBS contract would put the acquisition at risk.
Mississippi physicians have expressed concern that the HMA-BCBS stalemate could put rural, sole-provider hospitals and their patients in the crosshairs. Resource availability for patients in rural areas has been a concern in recent months. This is due to both states' refusal to expand Medicaid and a request by the Department of Health & Human Services that could threaten critical access hospitals.
To learn more:
- here's the Journal article