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Harrison, Regence fail to reach agreement

By Tad Sooter, Kitsap Sun, Bremerton, Wash.
McClatchy-Tribune Information Services

Aug. 21--BREMERTON -- A contract between Harrison Medical Center and Regence BlueShield terminated Thursday after the two sides were unable agree on a new deal.

Talks between the hospital, represented by parent company Franciscan Health Systsem, and the insurance company failed after months of wrangling over reimbursement rates. The contract between Regence and Harrison was set to expire July 30 but the two sides agreed to extend it through Thursday. No agreement was reached in the past three weeks, and representatives for Harrison and Regence confirmed the contract will terminate.

That means beginning Friday, Harrison and Harrison HealthPartners physicians will be "out-of-network" for most Regence insurance plans. People enrolled in those plans will have to pay higher out-of-pocket costs for care at Harrison or seek care from other providers. Harrison estimates 10,000 patients are affected. About 1,500 are Medicare Advantage members.

Regence still covers emergency care at Harrison. Regence spokeswoman Rachelle Cunningham said that Regence will reimburse its members directly for emergency services and that patients will be responsible for paying the hospital. Regence members receiving ongoing care at Harrison for illness or pregnancy are being advised to contact Regence customer service.

Affected Regence plans include BridgeSpan Health, Regence PPO, Medicare Advantage PPO and HMO, and Uniform Medical Plan. Harrison HealthPartners physicians will no longer be in-network for the Federal Employee Plan, but the plan's network still includes Harrison Medical Center.

Tacoma-based Franciscan Health System remains in-network with Regence. Franciscan's St. Anthony Hospital in Gig Harbor will be the next-closest in-network hospital for many Regence customers in Kitsap. A number of other medical groups in the area, including The Doctors Clinic, have contracts with Regence.

Regence customers reacted with frustration Thursday to news of the Harrison contract termination, taking to social media to blast both the hospital and the insurer.

In an earlier email to the Kitsap Sun, Belfair resident Francine McKinley said both she and her elderly father are covered by the Uniform Medical Plan for retired state employees, administered by Regence. The rift between Regence and Harrison will hurt many former government workers in the region, she said.

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"There are so many retired educators and other state employees in this area that are getting the state's Uniform Medical insurance, that it seems ridiculous that Harrison would not want to continue to serve them," McKinley wrote.

Lawyer Lynn Fleischbein said she signed up with Regence this year to provide comprehensive insurance for her and her office manager. Now she's lost in-network access to the largest health care provider in the area. Fleischbein said she'll be looking for a new insurance provider once her Regence policy expires.

"It makes me very angry that the company I have a contract with can't get its act together," she said.

The disagreement between Harrison and Regence centered around reimbursement rates for services.

Regence representatives claim the insurer already paid Harrison at a higher rate than comparable providers and said the hospital was asking for "double-digit" increases in the new contract. Cunningham said Harrison's proposals would have unreasonably raised costs for Regence members. The breakdown in negotiations was disappointing, she said.

"Unfortunately, the patient gets caught in the middle and has to choose whether to pay more or travel farther," Cunningham said.

Franciscan spokesman Scott Thompson said Regence was reimbursing Harrison at a lower rate than other major insurers and wanted a rate decrease in the new contract. The amounts Regence was willing to pay were below the norm for the West Sound market he said, and not enough to cover Harrison's expenses.

"We feel like they're trying to come between patients and their doctors," Thompson said.

In a letter to patients, interim Harrison President Joseph Kortum said he also was saddened by the outcome of the negotiations.

"We apologize for the inconvenience this may cause, and thank you for your understanding and giving us the opportunity to continue to provide your and your customers with exceptional health care," Kortum said.

Harrison affiliated with Franciscan last year, and Thompson said Franciscan will eventually negotiate insurance contracts for Harrison in conjunction with its other hospitals. In the meantime, Harrison is open to resuming talks with Regence, he said.

"We would be open if Regence wanted to come back to the table tomorrow," Thompson said. "It's not like we'll stop taking their calls."

Harrison-Regence quick facts

Contract ends: The contract between Harrison Medical Center and Regence BlueShield ended Thursday, meaning Harrison facilities and Harrison HealthPartners doctors are "out-of-network" for Regence customers and will cost more to use.

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Emergency services: Still in-network at Harrison.

Plans affected: BridgeSpan Health, Regence PPO, Medicare Advantage PPO and HMO, and Uniform Medical Plan.

Federal Employee Plan: It still includes Harrison in its network but not Harrison HealthPartners doctors.

Other facilities: Nearby hospitals that remain in-network with Regence include St. Anthony in Gig Harbor and most major Seattle hospitals. Local urgent care clinics in-network with Regence include The Doctors Clinic facilities and North Kitsap Family Practice & Urgent Care.

Info: From Regence, go to www.regence.com or call 888-344-6347. Harrison has posted information to www.harrisonmedical.org.

State help: The state insurance commissioner provides resources for consumers. Go to www.insurance.wa.gov, or call 800-562-6900.

___

(c)2014 KitsapSun (Bremerton, Wash.)

Visit the KitsapSun (Bremerton, Wash.) at www.kitsapsun.com

Distributed by MCT Information Services

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