Some patients of a local hospital system may have to jump through more hoops to get insurance payments.
Community Health Systems plans to cancel its contract with Arkansas Blue Cross Blue Shield on Sept. 1 if a dispute over payment rates isn’t settled.
Hospitals involved are Northwest Medical Centers in Springdale and Bentonville, Willow Creek Women’s Hospital in Johnson and Siloam Springs Regional Hospital.
The Brentwood, Tenn.-based health system wants the insurer to increase its reimbursement rate.
At A Glance
Community Health Systems
Brentwood, Tenn.-based Community Health Systems operates eight hospitals and seven clinics in Arkansas.
Hospitals
• Northwest Medical Center-Springdale
• Northwest Medical Center-Bentonville
• Northwest Medical Center/Willow Creek Women’s Hospital, Johnson
• Siloam Springs Regional Hospital
• Medical Center of South Arkansas, El Dorado
• Helena Regional Hospital
• Forrest City Medical Center
• Harris Hospital, Newport
Clinics
• Northwest Benton County Physician Services, Bentonville
• Northwest Physicians, Springdale
• Siloam Springs Clinic Company
• Forrest City Clinic
• Harris Medical Center, Newport
• Helena Surgery Clinic
• South Arkansas Physicians Services, El Dorado
Source: Community Health Systems
Web Watch
Leaving Physicians
Arkansas Blue Cross Blue Shield has a list of Community Health Systems physicians leaving its network in a special note on the “Find a Doctor” or “Find a Hospital” sections on the Members page at arkansasbluecross.com.
Insurance companies have a set amount they pay for services, and those payment amounts are the root of this impasse.
Blue Cross sent a letter, dated Aug. 10, to more than 56,000 employer groups and fully insured members in 21 Arkansas counties about the potential changes. Max Greenwood, company spokeswoman, said thousands more letters were sent to self-funded groups.
“Arkansas Blue Cross already is paying CHS hospitals the same rate that we pay all other Arkansas hospitals for outpatient services. And for inpatient services, we actually pay more, on average, to CHS hospitals than we pay to other Arkansas hospitals,” according to the letter.
Arkansas Blue Cross Blue Shield is the state’s largest insurer with 435,410 fully insured clients as of the end of 2011, Greenwood said.
Pat Driscoll, Northwest Health System spokeswoman, said the hospital’s attempts to negotiate with Blue Cross have been under way for several months.
“Blue Cross Blue Shield Arkansas has not given any material adjustments to our hospital rates in several years, and our request for a basic increase for inpatient and outpatient care, in line with our costs, was warranted,” she said.
Driscoll said the health system wants reimbursement increases to help offset increased costs in areas including employee salaries and benefits, new technology and supplies.
Both sides indicated they would like the issue resolved, but neither party wants to budge.
Alice Jones, spokeswoman for the Arkansas Insurance Department, said it’s common for issues to arise in contract negotiation and they are usually resolved.
“It’s uncommon for a contract to be terminated,” she said.
Slight changes are imminent if a new contract isn’t implemented.
“Patients with Blue Cross Blue Shield coverage can continue to utilize our hospital as they have in the past, and we will work with each patient on an individual basis going forward,” Driscoll said.
Greenwood said Blue Cross will continue paying the same level of reimbursement rate for services received at Community Health hospitals and clinics.
The change will be in how the claim is paid. Arkansas Blue Cross wouldn’t be under contract with Community Health, so payments would be made to the patient who is responsible for paying the medical facility.