Know the Facts About Mission Health’s Decision to Leave Blue Cross NC’s Network
MISSION IS NOW OUT-OF-NETWORK.
Since Mission Health decided to remove its doctors and hospitals from our network, the system has been aggressive in blaming Blue Cross NC for the choice it made. Their latest tactic is to intentionally use misleading data to justify their demands for higher payments from our customer.
Mission Health demanded increases in the fees we pay them. This makes premiums and out-of-pocket costs higher for our customers. We work hard to keep health care and health insurance costs as low as possible, and most of the hospitals in our state share this goal. We’re disappointed Mission is canceling their contract instead of working with us to keep things as affordable as possible for our customers.
As a result, Mission Health facilities are out-of-network. This includes hospitals, outpatient facilities, and most healthcare providers.
Mission Health is the only North Carolina health system leaving the Blue Cross NC network. Here are some things you need to know about this change.
To support our customers make the transition we continue to published Q & A’s on the Mission Health Frequently Asked Questions page.
It was Mission Health’s Decision
Mission Health has said that they simply threatened to cancel their contract. They have told some groups that Blue Cross NC ended the conversations. That’s false.
Mission Health’s contract with Blue Cross NC has no expiration date. But in early July, they ended good faith negotiations and canceled their contract with us. This will force our customers to pay higher prices if they use a Mission Health facility for care. And that’s not all. Mission Health also canceled their contract to serve Blue Cross NC’s Medicare Advantage customers – even though that contract wasn’t even part of the recent negotiation.
Mission Health Refuses to Slow the Increase of Health Care Costs
Mission Health claims that Blue Cross NC proposed a reduction in fees. That’s just not true. Blue Cross NC proposed a slowdown of their price increases.
Mission Health already receives higher prices than similar hospitals in North Carolina. And they have gotten increases from Blue Cross NC customers every year for the past three years. But even as more than 40 other hospitals in the state have agreed to work with us to keep costs for customers down, Mission Health has demanded even higher prices. Enough is enough.
Higher Fees for Mission Health Mean Higher Costs for Customers
Mission Health and its surrogates have made confusing statements that seem to imply that the increases they demand from Blue Cross NC don’t affect the prices our customers pay. That’s simply false.
Health insurance premiums and out-of-pocket costs are directly related to the prices insurers negotiate with hospitals. The price increases Mission Health demanded would have made health insurance premiums and out-of-pocket costs even higher for our customers. We know that health insurance is already expensive, and we’re working hard to find ways to hold costs down.
Blue Cross NC Customers Should Not Have to Pad Mission Health’s Margins
Mission Health has claimed that they need more money from Blue Cross NC customers in case changes in the Affordable Care Act (often called Obamacare) or Medicaid negatively affect their finances. We disagree.
Asking our customers to make up for potential shortfalls in other types of coverage isn’t right. 81 cents of every premium dollar our customers pay goes directly to pay for health care for our policyholders. We think it’s wrong to ask our customers to build a financial cushion for Mission Health.
Some Blue Cross NC Customers Will Still be Able to Use Mission Health Facilities
Customers already in a treatment plan for certain conditions such as cancer treatment or maternity care at a Mission Health facility may be able to keep receiving treatments as part of our Continuity of Care program. (BCBSNC will work to identify members who may qualify for this program, and they will get a separate letter from us.)
And emergency care is always covered as an in-network benefit. In the case of an emergency, Blue Cross NC customers should go to the nearest hospital. Prior authorization is never required for emergency care.
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