Negotiations threaten Springfield city employees' health care at Baystate

SPRINGFIELD — The health insurance company providing coverage for many Springfield city employees said Baystate Health is poised to stop accepting its members as patients after Dec. 31.

In a recent letter to its insureds, Wellpoint Insurance said it has been unable to renegotiate a contract with the region’s largest health care provider, and its current contract outlining reimbursement rates with Baystate expires at the end of the year.

“If this were to happen, nearly half of my city employees, over 2,500 city employees and some retirees, and their families would be adversely impacted. This simply is unacceptable,” Mayor Domenic J. Sarno said in a statement Thursday evening.

Meanwhile, Baystate spokesperson Heather Duggan said the 141-year-old health care system was negotiating for eight months in good faith with the insurance provider.

“Wellpoint’s proposed agreement is significantly below other health plans that contract with Baystate Health — both in terms of payment and proposed increases," Duggan’s statement says. “Responsible agreements between physicians and hospitals with insurance companies allow us to attract and retain health care professionals, bring new services to the community, invest in new technology and enhance our facilities.”

Wellpoint said in its letter — which was provided by Sarno’s office — that it rarely is unable to come to an agreement with a hospital provider, but Baystate wanted to hike its prices.

The proposed increase would be “more than three times the rate of inflation. Members and taxpayers can’t afford these drastic price hikes,” Wellpoint’s letter reads.

The insurance company said the proposed hikes would mean overall increases in the cost of care, including premiums and copays.

A spokesperson for the insurance company said Baystate had rejected all of Wellpoint’s offers to maintain the affordability of health insurance for its members in negotiations.

“It is solely Baystate Health’s decision to reject Wellpoint members,” the letter continued.

Wellpoint Insurance, formerly known as UniCare Massachusetts, is a health care insurer through the Group Insurance Commission of Massachusetts, an agency that provides health insurance and benefits to state and municipal employees.

The insurance company said it is still hoping to reach an agreement with the regional health care provider by the end of the year.

Meanwhile, Sarno and state Rep. Carlos González, D-Springfield, in statements urged both sides to continue talks so that health care for Springfield’s municipal employees is uninterrupted.

“Our beloved Baystate Health stands as the largest hospital and health provider in Springfield, making it vital for our community’s health and well-being,” González said. “I hope both parties return to negotiate a mutually beneficial outcome that secures the healthcare needs for my constituents.”

Losing access to Baystate Health in January does not affect a member’s insurance plan, Wellpoint’s letter said. Members can still go to Baystate until the end of the year. Wellpoint also said its plans will cover emergency care at any hospital.

On a webpage set up to provide updates on the situation, Wellpoint said the Baystate locations affected by the negotiations include those in Palmer, Westfield, Greenfield and Springfield.

Also affected would be access to Baystate doctors and services such as imaging, labs and home health.

Behavioral health care, however, remains unchanged for insureds of Wellpoint, as the company said its behavioral health arm inked a separate agreement with Baystate.

The contract dispute comes weeks after Baystate announced efforts to restructure following several years during the pandemic when it saw operational losses in the hundreds of millions of dollars.

Baystate’s new CEO Peter Banko said in October the health care provider needed over the next two years to boost revenue and cut expenses by $225 million.

“To be successful we have to grow revenue by 6 to 8% a year,” Banko said in an interview in October. “We’ve got to go [into] a growth mode and we’ve got to trim expenses.”

In November, Baystate said it had cut 134 leadership jobs.

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