Here’s a rundown on the changes of keenest interest to insurance advisors...
July 08--BREMERTON -- Harrison Medical Center could fall out of network with a second insurance company in eight months.
The hospital and Regency BlueShield haven't been able to reach agreement on new contract rates. The existing deal expires July 30. The Seattle-based insurer sent letters to patients June 30 informing them how their choice of medical providers and out-of-pocket costs could be affected.
"Basically it boils down to how much they're going to pay out of their pocket," Regence spokeswoman Rachelle Cunningham said. "If you're in the network, your plan is going to pay quite a bit more. It leaves people open to greater out-of-pocket expense, which, depending on the service, could be quite a bit."
About 10,000 to 11,000 Harrison patients are covered by Regence BlueShield, said Scott Thompson, spokesman for Franciscan Health System, Harrison's parent company.
The sticking point is reimbursement.
"Our concern is that we maintain an economically sustainable health care system," Cunningham said. "They're concerned with making what they feel they need to make. We need to keep talking and reach something that's acceptable to everyone, including our members."
Harrison sent an update to patients Tuesday saying the medical center tried to reach a deal with Regence that helps it keep up with increasing costs of technology, medicines, labor and energy but failed to negotiate reimbursement rates that are fair and comparable with other insurers.
"We understand these negotiations are sometimes tense and tenuous and both sides want to make sure they can meet in the middle," Thompson said. "We want to make sure we're providing the best affordable health care for our patients in Kitsap County and want to ensure we're getting fair reimbursement from the insurance companies to do that."
Harrison and another insurer, United Healthcare, failed to renew a contract that expired Nov. 30. About 1,200 Harrison patients were covered by the company.
If Harrison and Regence can't reach accord, patients will have to pay out-of-network costs to continue there or find a preferred hospital or provider. The nearest hospital for many is St. Anthony's in Gig Harbor, which, like Harrison, is part of Franciscan.
Doctors from Harrison Health Partners would no longer be in the network, either.
For urgent care, Regence does cover The Doctors Clinic in Bremerton, Poulsbo and Bainbridge, North Kitsap Family Practice and Urgent Care in Poulsbo, and Franciscan Prompt Care and Multicare Urgent Care Center in Gig Harbor.
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