SPOKANE, Wash. — Thousands of MultiCare patients in Washington state are at risk of losing treatment if they have Premera Blue Cross insurance.
The current contract between the two nonprofits expires on May 31st. If no agreement is reached, people with Premera Commercial, Individual Exchange, and Medicare Advantage health plans will be out of network.
According to Premera, contract negotiations began with a termination notice, which was not implemented. If passed, all lines of business would be affected, including commercial insurance, personal insurance, University of Wisconsin Student Insurance, and Medicare Advantage plans. The termination does not affect his HMO plans in Premera Medicare Supplement or the Sherwood HMO Network.
Premera said he would continue negotiations to reach an agreement that benefits everyone, but expressed dissatisfaction with the negotiation process.
“We have worked hard to reach an agreement with the MultiCare team. That said, MultiCare’s approach to these negotiations is not what we expected given our history and partnership. It wasn’t as rational as it used to be,” Premela said. “We are very disappointed in the attitude and lack of progress in these negotiations.”
The main issue at hand is how much Premera is willing to pay MultiCare for hospitals to treat people covered by its health insurance plan.
But Multicare argued that rising medical costs and inflation justified the higher payment.
“Our rates have not kept up with the basic increases we are asking our members and employers to pay. But MultiCare Premera’s rates have also not kept up with how other health systems pay. ,” said Alex Jackson, senior vice president and chief executive of MultiCare, Inland Northwest and Central Valley region.
MultiCare said it looked forward to reaching a fair agreement that would allow it to continue providing “high quality care.” Multicare added that for the past five years, Premera has not lived up to its end of the bargain.
“Since 2019, Premera has reimbursed Multicare at levels well below the rate of inflation,” Multicare said. “Patient confusion is the last thing we want, but we need Premera to pay for the actual costs of care so we can invest in the doctors, medical technology and innovation, and community programs people rely on.”
If Multicare and Premera cannot reach an agreement, the following facilities will be affected:
- Auburn – MultiCare Auburn Medical Center
- Covington – MultiCare Covington Medical Center
- Olympia – MultiCare Capital Medical Center
- Puyallup – MultiCare Good Samaritan Hospital
- Spokane – MultiCare Deaconess Hospital
- Spokane – MultiCare Valley Hospital
- Spokane – Lockwood Clinic
- Tacoma – MultiCare Allenmore Hospital
- Tacoma – MultiCare Mary Bridge Children’s Hospital and Health Center
- Tacoma – MultiCare Tacoma General Hospital
- Yakima – Multicare Yakima Memorial Hospital
- Indigo Urgent Care Clinic
If no agreement is reached, people in these areas will have to find a new doctor or pay out-of-network fees. Premera said he will work with people with chronic and serious illnesses to ensure their treatment is not interrupted.
Approximately 103,000 members across the state will be affected. Meanwhile, about 11,000 members in Spokane will be affected.
Patients can receive emergency treatment if needed. Premela said emergency medical care will always be covered by in-network costs. In Spokane, patients can go to Providence Sacred Heart, Providence Holy Family, and Shriners Children’s.
Patients with Premera Medicare Supplement plans or HMO plans with the Sherwood HMO Network will not be affected if no agreement is reached.
“We wish things hadn’t gone this far. But we need to strike a balance during negotiations. One is ensuring that our members across the state have access to affordable health care. But then, on the other hand, you have to recognize that that important partner is the multicare partner, and you have to compensate them fairly for their costs, so you have to balance that. “We have to do it,” said David Condon, vice president of Premera Blue Cross of Eastern Washington. said the former Spokane mayor.
For more information and frequently asked questions, please visit Visit the Premera website.
