Blue Cross Blue Shield of Mississippi is breaking ties with the state's second largest hospital company.
Mississippi's largest insurer notified Health Management Associates, which owns 10 hospitals throughout the state, of its decision effective end of August. By ending the contracts, Blue Cross will pay the hospitals lower out-of-network rates, reported the Associated Press.
The move comes only a few weeks after HMA sued Blue Cross for $13 million for allegedly improperly reducing inpatient payments for services. HMA claims Blue Cross breached contracts by unilaterally changing terms, FierceHealthcare previously reported.
"We believe that it is the goal of HMA to maximize profits," Tom Fentner, Blue Cross chief medical officer said in a statement. "We believe that such a goal is inconsistent with Blue Cross & Blue Shield of Mississippi's goal of managing health care costs for our members. This difference in philosophies is why we canceled their network agreements."
He added that when it comes to provider relationships, the insurer prioritizes cost management and ensuring its members obtain needed medical care "with the value of being covered by Blue Cross Blue Shield."
The issue could have economic impacts for Mississippi's healthcare market. Blue Cross holds 54 percent of the insurance market, while the 10 HMA-owned hospitals have about 10.4 percent of the average patient count statewide, the AP noted.
To learn more:
- read the Associated Press article