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In this time of uncertainty in the health care industry, one thing is certain: skyrocketing medical costs are squeezing North Carolina families and businesses more than ever before. That’s why we are extremely disappointed that Mission Health System (Mission Health) has chosen to cancel their 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.

After several months of negotiations with Mission Health to reach an agreement that would help address rising health care costs in Western North Carolina, the hospital system has refused to budge. This means Mission Health will no longer be a part of our network beginning Oct. 5, 2017. The health system has chosen to become the only system in North Carolina outside of Blue Cross NC’s network. 

We have a long-standing history of supporting community hospitals. In fact, our roots go back 84 years in providing access to community hospitals in order to improve the health of North Carolinians.

Unfortunately, runaway costs have become too large of a problem to ignore. And it’s an issue that affects every customer and business. When costs become too high, it affects the ability of North Carolinians to access the care they need. Our top priority as an insurer is to ensure that our customers and our customers’ families get the high quality, affordable health care they need.

We must remain vigilant in fighting to rein in health care costs, and we’re doing this on a number of fronts.

WHAT HAPPENED?

The cancellation is happening because Mission Health has demanded rate increases that we can’t in good conscience ask our customers to pay.

Blue Cross NC customers already pay more for care at Mission Health than at many other health systems in the state. High costs directly contribute to higher premiums and out-of-pocket costs for our customers, and continued, significant price hikes are not sustainable.

Hospital costs for outpatient procedures and inpatient hospital stays account for nearly half of all medical costs for Blue Cross NC customers.[1] Mission Health is among the most expensive facilities for common inpatient procedures such as deliveries, knee replacements and imaging procedures like chest x-rays and CT scans.[2]

When hospitals ask for increases in the fees we pay them, that directly translates to higher insurance premiums for our customers. Rising medical costs are one of the most urgent issues facing North Carolina families. Recently, 43 other hospitals across the state have agreed to work with us to slow down unsustainable cost increases under terms consistent with Blue Cross NC’s proposal to Mission.

NEXT STEPS FOR OUR CUSTOMERS

We know that changing health care providers is not convenient, but we are dedicated to making sure this transition is as smooth as possible for our Western North Carolina customers. We’ll work with our customers and their doctors to help connect them with the care they need.

In addition, we’d like to share that:

  • In case of emergency, Blue Cross NC customers should always go to the nearest hospital. Emergency care is always covered as an in-network benefit. Prior authorization is never required for emergency care.
  • Services performed at Mission Health on or after Oct. 5, 2017, will be processed as out-of-network.
  • Through Blue Cross NC’s Continuity of Care program, customers who are pregnant or living with a chronic illness may be allowed to keep seeing their current doctors at Mission Health facilities or providers under in-network benefits. Blue Cross NC will contact customers who may qualify. Customers who have questions about the Continuity of Care program should call the number on the back of their membership ID cards.
  • If you are a customer in the area, continue to visit bcbsnc.com/missionhealth to learn more or call the number on your membership card for more information about how this decision impacts you.
     

[1] Insured business only based on Business Segment Report and GAAP income statement, 2016. Excludes group self-funded (ASO) business

[2] Blue Cross NC Treatment Cost Estimator, Chest x-ray, CT Abdomen  Pelvis, Vaginal Delivery, Knee Replacement

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