Insurer switches Tacoma health systems for coverage on individual plans

An insurer that nearly parted ways with MultiCare in 2024 in a contract dispute has moved away from the Tacoma-based health system for its 2026 individual-plan network including in Pierce County while retaining it for commercial plans.

Individual plans are purchased by those seeking medical insurance who are not covered by a commercial (employer) plan or government (Medicare or Medicaid), available through the health insurance marketplace or directly from insurers. Participants are typically self-employed or part-time workers.

Regence BlueShield, in a statement, told The News Tribune in response to questions, “To continue offering affordable access to health care in Washington, we made the decision to change the composition of our Individual plan network, beginning Jan. 1, 2026.”

It added, “We attempted to work with our current Individual plan network providers but were unable to secure reasonable rates that would not cause an undue financial burden on our members.”

The insurer said that starting in January, its Pierce County network “will be built around Franciscan Health System, including St. Clare Hospital and St. Joseph Medical Center, among other local and regional providers.”

Regence added, “MultiCare will no longer be in the Individual plan network in Pierce County; however, it will remain in our commercial plan (the health plans individuals get through their employers) network.”

Franciscan Health is the Pierce County portion of the merged Virginia Mason Franciscan Health. CHI Franciscan and Virginia Mason completed their merger in early 2021.

The News Tribune first learned of Regence’s action from an individual participating in a Regence plan via Washington Healthplanfinder.

MultiCare responded to The News Tribune’s questions about the change with its own statement on Dec. 3. It said it “disagreed with the way Regence has characterized our negotiations in their new individual insurance plans on the Washington Health Care Exchange.”

It added, “MultiCare is very interested in providing care to Regence members in the state. Unfortunately, we were not informed about Regence’s plans until October once their network had already been developed, leaving no opportunity for discussion regarding MultiCare’s inclusion.”

The Tacoma health system added that it is “talking with Regence about participating in their network for Pierce County to ensure we can continue delivering high-quality care to shared patients and members in the South Sound.”

MultiCare also noted that it will continue to be in-network for Regence exchange products in Yakima County.

In figures the health care system provided, the change affects 413 Regence members/MultiCare patients across Pierce, King, Thurston and Spokane counties.

“Our goal is to achieve an agreement that will allow us to continue providing high-quality care to the communities we serve – now and for years to come,” the health system added.

Regence, in its statement, said that it realized the “real impacts on peoples lives” such decisions have. “Our priority has been to ensure people affected by these changes are fully informed to make decisions that best fit their health care needs in 2026.”

“While we are not eager to lose members, we want to ensure individuals have in-network access to the providers they prefer,” it added. “Our intent is to continue offering access to high-quality health care while remaining financially sustainable for the long term.”

In 2024, Regence and MultiCare reached a deal to keep MultiCare in-network for those insured by Regence following a contract termination action invoked by the health system midway through its contract.

At the time, MultiCare blamed higher costs in health care overall made worse by inflation, while Regence had pushed back on the amounts of requested increases.

Previous reporting from The News Tribune contributed to this report.

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