Crisis averted.
Local residents and employees who are insured through Regence BlueCross BlueShield will continue to receive health care services through Moab Regional Hospital, after the two sides reached a last-minute contract agreement on Dec. 31, 2014.
Under the agreement, the hospital will remain a Regence in-network provider, so Regence members can still receive local care at “favorable rates,” according to a joint press release.
The two sides had been negotiating up until the final hours of last year, and representatives from both entities said in a statement that they are grateful they were able to reach a compromise.
“We would like to thank hospital leaders for working through the lengthy discussions with us,” Regence BlueCross BlueShield of Utah President Jennifer Danielson said. “We’d also like to thank our members, agents, brokers and employer groups for their patience and understanding when the negotiations reached a time-critical stage.”
“I am pleased we were able to come to a mutual agreement on contract terms,” Moab Regional Hospital CEO Robb Austin said. “I am especially pleased for those community members with Blue Cross coverage who can continue to utilize Moab Regional Hospital and our hospital physicians for in-network services.”
Neither side would comment on the agreement they finally reached, beyond the statements they made in their joint press release.
However, the history behind the now-resolved dispute is well known.
The health insurance giant first notified the hospital in July 2014 of changes that would be made to its existing contract. At the time, it was proposing to reimburse MRH on a fixed-fee for services basis, as opposed to the operating model at the time, when the hospital was reimbursed for a percentage of costs.
Hospital officials said earlier last year that the changes were “really drastic,” and would result in a net loss of 40 percent, or $2.6 million in reimbursement to the hospital.
Regence, meanwhile, said at the time that the reimbursement rate the hospital sought was significantly higher than prices for the same services that other community providers offered.
In late October, the hospital informed Regence that it would terminate negotiations by Nov. 15, 2014, in order to give its patients time to find new, in-network coverage before the contract expired. However, when that deadline came and went, hospital officials said they realized they needed to keep the lines of communication open.
Central Utah Insurance agent Renee Troutt said she welcomes the outcome that followed those additional negotiations.
“I’m elated,” Troutt said. “I think there are a lot of people that would have been adversely affected had they not come to an agreement.”
“I think that the majority of the insured population in Moab are with Regence,” she noted.
That includes people who work for private employers like Intrepid Potash, as well as U.S. Bureau of Land Management and National Park Service employees.
“Even the (federal) government employees here are all insured through BlueCross BlueShield,” she said.
When the outcome of the negotiations appeared to be less certain, Troutt’s office tried to roll its clients over to another in-network carrier that provided comparable deals. But that work was done to no avail, she said.
“After we looked at other options for them, we could not find something that was competitive with the other carriers,” Troutt said.
“I’m happy that they were able to compromise,” she added.
So is local resident and retiree Roy Vaughn, who previously raised concerns about the potential loss of insurance options.
“If they reached a compromise that’s acceptable to both BlueCross BlueShield and the hospital, I think it’s great, because it’s certainly a benefit to the people here who have insurance through Blue Cross,” Vaughn said.
“The focus should be on health care – not on money,” he added.
Regence is sending follow-up letters to affected members and groups regarding the agreement, and the continued in-network status of the hospital.
Hospital will remain in-network provider for Regence
