Florida Blue, Broward Health hit standstill over costs. What it means for patients

Thousands of people who have health insurance through Florida Blue may find themselves paying a heftier bill the next time they seek care at Broward Health, one of three public hospital systems in South Florida and one of the largest in the country.

As of July 1, Broward Health is no longer an in-network provider for Florida Blue, ending a decades-long agreement with one of the largest insurers in the state. Florida Blue made the announcement this week, stating that Broward Health “has chosen to leave the Florida Blue network” after rate negotiations between the two organizations fell through.

For Broward Health patients who have insurance through Florida Blue, that means they may need to find new doctors who are in the Florida Blue network to get cheaper — or covered — medical care. If not, they might find themselves paying a heftier bill for primary and specialty care at Broward Health, which is now an out-of-network provider for Florida Blue members.

“We are disappointed that Broward Health has chosen to leave our network of providers, and hope this is temporary,” Florida Blue said in a statement. “Unfortunately, Broward Health’s rate demands remain excessive and unsustainable, and would burden our community with much higher health care costs. We ask their senior leaders to return to the negotiating table and work with us in finding a reasonable solution that protects our members, preserves affordability, and works for everyone.”

In a blog post for patients, Broward Health said that Florida Blue has “historically undervalued the care our team members provide” and that its discussions with the health insurer were about “fairness.”

The public hospital system said it asked Florida Blue to reimburse its team at levels that are “comparable” to what it reimburses other South Florida health care providers and the rates provided by other insurance companies for the same services.

Florida Blue said it notified about 18,000 members in May about the situation, including patients who had received care at Broward Health in the last six months or who have a Broward Health primary care doctor.

Broward Health, which mainly serves central and northern Broward County, is one of the 10 largest public health systems in the country, with five hospitals and more than 50 health centers and physician practices. It’s one of two public hospital systems in Broward County, the other being Memorial Healthcare System, which mainly serves southern Broward.

Who is affected?

As of July 1, all Broward Health services, facilities, clinics and physicians will be impacted by the standstill between Broward Health and Florida Blue, which was previously known as Blue Cross Blue Shield.

Patients affected by the stalled negotiations include those with “commercial (employer-based), individual marketplace and Medicare Advantage” plans, according to Broward Health. The hospital system said Medicare Supplemental and Medigap plans would not be impacted.

Florida Blue members can also still go to Broward Health for emergency care, as “ER and emergency services are always covered at in-network cost share, even at out-of-network facilities,” according to Florida Blue.

The health insurer said some patients may still be able to continue getting in-network care at Broward Health for a certain period of time under federal and state protections for continuity of care. This includes people who are pregnant or who are “undergoing active treatment for serious and complex health conditions, or in post-operative care following surgery,” according to Florida Blue.

Patients with questions can visit Florida Blue’s website or call the number on the back of their member ID card for more info specific to their plan.

This article will be updated.

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