LOCAL

Commissioners scold Blue Cross NC, Mission Health over contract impasse

Mark Barrett
The Citizen-Times

ASHEVILLE – Blue Cross Blue Shield of North Carolina and Mission Health should back up their talk about serving the community by talking to each other about a new contract, Buncombe County commissioners say.

Representatives of both nonprofit organizations spoke at a commissioners' meeting Tuesday about a contract dispute that will mean most non-emergency care at Mission Hospital and other health care providers it owns would be out of network for Blue Cross NC customers - and thus more expensive - as of Oct. 5.

Both said they are acting in the best interests of their customers, but some commissioners weren't happy that the sides are not currently negotiating with each other.

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"When I listen to both of you, I'm sorry that I didn't wear my short pants here today," said Commissioner Al Whitesides, apparently comparing assurances of concern for the public to so much manure.

"We're sick and tired of hearing you say how much you care for us, what you do for us," he said. "We want to see something done, and it's time to sit down and talk to each other."

Mission gave notice it was terminating its contract with Blue Cross NC on July 5. Mission President and CEO Dr. Ron Paulus said then that Mission had been negotiating for months with Blue Cross NC but couldn't get Blue Cross NC to move beyond an offer that would essentially mean no increase in payment to Mission.

Jill Hoggard-Green, president of Mission Hospital and chief operating officer of Mission Health, told commissioners that if Mission had not taken that step, the terms of its existing contract mean it would have been locked into charging existing rates indefinitely despite rising costs for labor and supplies.

Mission acted to avoid that, but, "We are very willing to be back at the table," she said.

Patrick Brady, director of major and national accounts for Blue Cross NC, said that as a matter of policy, the insurer ends negotiations with health care providers once a notice of termination is given.

When that happens, "It plays out in the media. It is not a good outcome and there is not open communication," he said.

April Umminger, head of public relations for Blue Cross NC, said after the meeting that the insurer's policy is needed to ensure that those it covers find new providers that take Blue Cross NC's insurance.

"If patients believe that we are still negotiating and that a hospital is unlikely to go out of network, then they are less likely to find and transition their medical care to providers that are in network in time," she said.

Brady told commissioners Blue Cross NC seeks a one-year pause in rising health care costs after many years of increases. He said Hoggard-Green's prediction of no increases if Mission does not terminate its existing contract is "very catchy, but it's not true."

Hoggard-Green said Blue Cross NC must be willing to negotiate and must realize that the costs of things Mission has to pay for will continue to rise. The percentage increases in rates Blue Cross NC has been charging employers have been in the double digits, she said.

"I see a resolution to this, but it does mean that both parties must be at the table and we must have the resources to provide care," she said.

Some commissioners were unimpressed.

"You guys need to get together and figure this out. This is not acceptable," said Commissioner Joe Belcher.

When Hoggard-Green said a few moments later that Mission is anxious to resume negotiations, Belcher interrupted her, saying, "Then you need to show us."

Commissioner Mike Fryar complained about Mission buying up physician practices in the county and at one point told Hoggard-Green: "Don't blow smoke. You need to get back to the table."

Commissioner Jasmine Beach-Ferrara said the positions of Blue Cross NC and Mission reflect "a classic dynamic of brinksmanship" and suggested the two sides employ an outside mediator.

Neither Brady nor Hoggard-Green agreed to do that.