Bend, Oregon Update
Beginning October 1st, St. Charles Health System will no longer be part of Cigna’s medical network, which might impact many patients in central Oregon. This decision follows stalled contract negotiations between the two entities.
Cigna Healthcare reported that the Bend-based health system informed insurers earlier this year of its plan to exit the network. Cigna claims that the contract impasse arises from what it refers to as “unreasonable demands” from St. Charles leadership, including a proposal described as a “take it or leave it” deal with an uncertain refund rate.
“Like many healthcare providers nationwide, St. Charles Health System acknowledges challenges such as labor shortages and related cost pressures,” Cigna noted on its website. “However, there remains an obligation to maintain affordability and predictability in medical costs.”
Cigna highlighted that its primary business with St. Charles comes through self-funded employer-sponsored programs. If no agreement is reached by the deadline, Cigna members enrolled in Open Access Plus, PPO, or LocalPlus plans will be deemed out of network when seeking care at St. Charles facilities.
The facilities impacted include:
- St. Charles Medical Center – Bend
- St. Charles Medical Center – Redmond
- St. Charles Medical Center – Prineville
- St. Charles Medical Center – Madras
St. Charles Health System, which serves many in central Oregon, states that the disputes mainly revolve around contractual language, particularly concerning medical insurance coverage denials.
“We aim to establish a mutual understanding with insurance companies and rectify inefficiencies within a complex payment system that increases costs for everyone, particularly patients,” St. Charles said in a statement. “After months of negotiations with Cigna, we hit an impasse because they did not agree to essential modifications regarding inefficiency, management liability, and other critical matters.”
The Health System estimates that around 5,000 patients could be affected by the contract termination, although St. Charles treated over 186,000 patients in the past year.
Both parties express regret about the potential effects on patients and are dedicated to assisting members in exploring their care options.
Patients with inquiries are encouraged to reach out to Cigna Member Services or visit the St. Charles website for additional information and updates.
