Providence, Premera agree on network terms

Jan. 30--Providence, Eastern Washington's largest medical provider, is back in the coverage network for Premera Blue Cross and Lifewise, the area's largest health insurers.

Providence and Premera announced their new agreement Wednesday. It takes effect Saturday. It applies to individual and small-group policies for 2014, whether purchased on the Washington Health Plan Finder website, or outside it.

Insurance rates were not affected, according to Premera. But the agreement does mean Premera customers will be able to get care from Spokane-area Providence providers at lower cost, and with fewer hassles, than if Providence had remained out-of-network.

Providence operates Spokane'sSacred Heart Medical Center, Holy Family Hospital, and a network of approximately 500 physicians and medical practitioners, working at 50 area clinics.

Late last year, as consumers began shopping for individual insurance on the Health Plan Finder, they began noticing that the Spokane area's huge Providence system was missing from the list of in-network providers for policies sold by Premera and Lifewise. Lifewise, owned by Premera, is the only insurance carrier selling policies in all 39 counties of Washington on the Health Plan Finder.

When questions arose last year about why Providence and Premera had not been able to come to an agreement for the 2014 insurance policies, Providence talked about the quality of its services and noted that it would be in-network for insurance sold by other carriers, such as Group Health. Premera, meanwhile, talked about its determination to sell an "affordable" product and said consumers would get fine care from Spokane-area providers in its network: Deaconess and Valley hospitals and the Rockwood physicians network.

On Wednesday, Providence and Premera praised each other, their new agreement and what it means for consumers.

"Providence is a high quality provider with tremendous value in Spokane," said Rich Maturi, a senior vice president at Premera. "We're happy to add Providence to our value-based network while holding our highly competitive rates steady."

"During this time of dramatic change in health care, we know that Providence and Premera will need to forge new ways to work together to provide patients access to high-quality care at a more competitive cost, and Providence welcomes this opportunity," said Scott O'Brien, chief strategy officer for Providence Health Care in Spokane.

Eric Earling, a Premera spokesman, noted that implementation of the federal Affordable Care Act placed intense deadlines on everybody in the health care system last year: insurance carriers, care providers and government regulators. Consumers, meanwhile, have been asking his company lots of questions, Earling said.

One of those questions, about why the region's largest hospital was not in-network for the region's largest insurance carrier, has now disappeared.

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