Mission Health says it may stop accepting Blue Cross Blue Shield insurance later this year, a major decision that would affect thousands throughout Western North Carolina. Mission said in a statement that if no agreement is reached by October 4th, Blue Cross Blue Shield members would not have ‘in-network’ access to its facilities. That means patients would have to seek care elsewhere, or pay more out of pocket.
Blue Cross Blue Shield said Mission would be the lone health system in North Carolina not to accept them, the state’s largest insurer. The dispute is over payment rates the insurer makes to the health system. Mission claims Blue Cross Blue Shield’s current offer reduces those rates to levels that would endanger its ability to keep up with rising operating costs. “BCBSNC’s latest proposal imposes effective payment rate reductions to our health system at a time when modest annual increases are more important than they have ever been,” said Charles Ayscue, Senior Vice President, Finance and Chief Financial Officer at Mission Health. “Even if we earn every dollar of pay for performance incentives offered by BCBSNC, we could at best get back to zero for three straight years. It’s simply impossible to keep up with rising medical supply, pharmaceutical, and other operating costs, let alone provide future wage increases to our fantastic team members without appropriate annual adjustments to our payment rates from BCBSNC in the coming years.”
Blue Cross Blue Shield responded by saying its customers already pay more for care at Mission than at many other systems. “Rising medical costs are one of the most urgent issues facing North Carolina families. More than 43 other hospitals across the state have agreed to work with us to slow down unsustainable cost increases,” said Mark Werner, Vice President of Provider Network at Blue Cross NC. “We are disappointed that Mission Health chose to cancel its contract with us rather than work toward a solution to keep health care and health insurance as affordable as possible for our customers in Western North Carolina.” A spokeswoman for Mission says they want to continue to negotiate over the next three months to avoid dropping Blue Cross Blue Shield - the largest insurer in North Carolina, covering 72-percent of state residents who have insurance. It’s also the lone provider offering insurance through the Affordable Care Act in most of the state, including Western North Carolina. Mission statementBlue Cross Blue Shield statement