Jacksonville, Florida — Thousands of Florida Blue customers are in limbo as they wait to see whether Baptist Health Systems will remain in their health care payment network.
In just seven days, Florida Blue's insurance contract with Baptist Health expires.
The two sides are still negotiating a contract, and if no agreement is reached by Oct. 1, Baptist Health will be considered out-of-network for about 600,000 Florida Blue customers across the region.
These contract negotiations will impact Florida Blue customers who use Baptist Health facilities for their health needs, and those receiving specialty care at Wolfson Children's Hospital and MD Anderson Cancer Center should also pay close attention to these contract negotiations.
The problem is all about money.
Contracts between hospitals and insurance companies typically determine the prices that insurance companies pay hospitals for various medical services.
Baptist Health argues it is shouldering too many costs due to labor shortages, record inflation and rising costs of medicines and supplies.
“Over the past few years, our health system has served as a 'shock absorber' for our community, providing the vast majority of care throughout the pandemic and navigating the difficult times that followed,” Dr. Timothy Gruber said in a video statement to patients. It was posted online. Gruber is the chief medical officer for Baptist Health Systems.
Meanwhile, Florida Blue officials say patients would be financially affected if they agreed to Baptist's proposal, with a spokesperson telling News4JAX that the latest request would mean more than $1 billion in new costs.
“Unfortunately, if Florida Blue agrees to the outrageous demands that Baptist Health Jacksonville is making in the current negotiations, health care costs will skyrocket,” Darnell Smith said. In a recent video statement,President of Florida Blue North Florida; “Our current offer is fair, market-competitive and generous.”
Message to patients Baptiste Jacks “This indicates that the parties are moving forward toward an agreement,” Baptiste said in a statement to News4JAX on Monday.
“People want to know why an agreement hasn't been reached yet. The problem is at the starting point. We have been underpaid by Florida Blue for years and have received zero fee increases for our physicians since 2016. This disparity has grown every year. We do not want to be drawn into this conflict, but we must make gains to remain a viable health care option for our community. Rather than stepping back and blaming negotiations for annual fee increases, we need Florida Blue to step up and bring our rates closer to what similar health systems pay. That's their choice, not ours.”
Florida Blue said the latest proposal it received from Baptist Health would see rates increase 58% over the next five years, averaging about 10% increases per year.
Randy Wise, executive director of the Jacksonville Police Officers & Firefighters Health Trust, said the significance of Florida Blue and Baptist Health agreeing to a new contract weighs heavily on local first responders and their families.
Florida Blue is the designated health insurance provider for city employees, emergency responders and Duval County Public Schools employees.
Wise is pressuring the two companies to reach a deal to avoid losing their insurance.
“As you know, firefighters are at a very high risk of developing cancer because of the nature of their work, and we have police officers who come to MD Anderson who are battling cancer and their futures are uncertain,” Wise said. “Police officers and firefighters would never turn away Jacksonville residents when they come to us for help, and we ask that you not turn your back on these individuals.”
Florida Blue intends to continue paying claims for services performed at Wolfson Children's Hospital, as well as claims for pregnant women currently under its care as part of what's called continuity of care.
Emergency room visits and certain other services will still be considered in-network after Sept. 30.
But if the parties don't reach a new agreement by October, MD Anderson cancer patients will be considered out-of-network.
If members have questions about these network changes, they can call the number on the back of their membership card or visit the Florida Blue Center in person for assistance.
For more information on other major insurance companies accepted by Baptist Health, click here.
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