A year after split with Blue Cross, Springfield Clinic offers patients new health plan

Springfield Clinic is rolling out a health plan that will give patients in-network access to doctors.

The move comes after last year's dispute with Blue Cross Blue Shield of Illinois that forced at least 55,000 customers to find new healthcare providers.

It is the first time Springfield Clinic has offered such a plan in its 80-plus-year history.

"We're giving employers and patients the control back," said Zach Kerker, Springfield Clinic's vice president of brand experience and advocacy.

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The health plan and a website launch this week.

Called "Springfield Clinic Advantage," it will be available for employers with 10 or more employees throughout central Illinois and will include all Springfield Clinic providers. The plan also provides Tier 1 access to a nationwide network of hospitals and providers through the national insurer HealthLink.

The adoption of the plan wasn't a specific reaction to the Blue Cross situation, Kerker said, "but it probably expedited our necessity to do something like this.

"We've heard from employers and patients who have asked for a more direct relationship with Springfield Clinic," he added. "This plan offers that. It guarantees you'll never be out of network with your Springfield Clinic doctors. It was developed locally by people who understand the healthcare needs of patients in central Illinois. Ultimately, it's just another way for patients to get access to their provider. Many patients felt like there were barriers to their physician recently and this allows patients a way to get back in the door."

Springfield Clinic partnered with Consociate Health Decatur to develop the plan.

Many traditional health insurance plans limit a patient's ability to make health care decisions, said Darren Reynolds, CEO of Consociate Health.

If a person needs a colonoscopy, Reynolds said, the team will work with the person to get that procedure done quickly and safely and in the most cost-effective way.

"Many procedures cost far less in an outpatient surgery center than at a hospital, and patientsshould know that in advance," Reynolds said.

The removal of Springfield Clinic resulted in at least 55,000 Blue Cross customers needing to find new doctors or file continuity of care requests with Blue Cross, though Springfield Clinic officials put the number at double that.

Kerker said Springfield Clinic's number came from any patient who had received any services for the past three years and had Blue Cross.

Blue Cross was fined $339,000 for violating the Network Adequacy and Transparency Act, a state law from 2017.

Contact Steven Spearie: 217-622-1788, [email protected], twitter.com/@StevenSpearie.