Contract negotiations between Stillwater Medical Center, BlueCross BlueShield of Oklahoma reach impasse [Stillwater NewsPress, Okla.]

Dec. 29—Stillwater Medical Center and BlueCross BlueShield of Oklahoma have come to an impasse in negotiations over who should pay for inflating costs of medical care. Both entities have announced Stillwater Medical facilities will no longer be a BCBSOK in-network provider on May 1, 2023, unless they can compromise.

BCBSOK says SMC hospitals in Stillwater, Blackwell and Perry will no longer be in Blue Traditional, Blue Choice or Blue Preferred networks. SMC will also leave Blue Cross Medicare Advantage HMO and Blue Cross Medicare Advantage PPO networks on Jan. 1, 2023.

On Oct. 4, SMC notified Humana Medicare Advantage members that the regional hospital will no longer be a preferred in-network provider as of Jan. 1, 2023. BCBSOK told the News Press they will notify members if SMC becomes no longer in-network.

SMC and BCBSOK have created web pages outlining their side of why negotiations have come to a standstill.

On their website, SMC claims their costs have increased 26% since 2019 and that they will be unable to maintain a high level of care if they accept reimbursement contracts from insurance provider networks that do not keep pace with inflation.

BCBSOK's website says that SMC wants to increase prices by several times the rate of inflation. BCBSOK maintains they are trying to protect local businesses and employees from steep price increases.

According to SMC's webpage, the collective rate payments for BCBSOK's patients comprise 21% of Stillwater's patient base.

SMC has stated a deadline of Dec. 31 to reach an agreement. While BCBSOK communications manager Tricia Ament shared there is no deadline and that BCBSOK is open to returning to negotiations.

Both the City of Stillwater and Oklahoma State University use BCBSOK to provide health and medical insurance to their employees. According to City of Stillwater Communications Director Dawn Jones, the city doesn't know how their employees will be impacted at this time.

The hospital's Board of Trustees voted to table a report by SMC Chief Financial Officer Alan Lovelace on negotiations with BCBSOK at the Dec. 20 Stillwater Medical Center Authority meeting.

In a financial report by Lovelace, SMC will see a $7-8 million loss for 2022 and forecasts for 2023 show increased expenses. However, the hospital should see a $5,000,000 profit at a 1.2% margin. Lovelace noted a profit margin of 3-4% is ideal and allows the hospital to keep up with maintenance and cost increases.

"We need to do all we can to manage expenses during this season," Lovelace said.

The Board of Trustees also approved naming the hospital's new neonatal intensive care unit the OnCue NICU after the gas station and convenience store company made a $1,000,000 donation.

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