Still No Deal Between Blue Cross Blue Shield And Many Rural Hospitals

Wednesday, August 30th 2017, 4:25 pm
By: Dana Hertneky

Integris and Blue Cross Blue Shield have reached an agreement just days before the current contract was set to expire. 

The two year deal means BCBS members will be in-network at all Integris facilities. There are still thousands of Oklahomans, however, that may have to make a choice between their insurance and their doctor.

The Prague hospital is one of numerous rural hospitals across the state that are still negotiating with BCBS.  Folks there are still extremely concerned about what will happen to the hospital if an agreement isn't reached.

Rebecca Podest has been a patient at the clinic at the Prague hospital for most of her life. Mary Ann Ward's been taking care of her for a lot of that time.

“She knows everything about me and, no, I don’t want to change doctors,” said Rebecca. “But according to Blue Cross, Blue Shield that’s what I’m going to have to do.”

Hospital administrators say BCBS wants to drastically lower reimbursements.

“Currently Blue Cross is asking for a payment reduction of 30% to 40% of what they have been paying us historically,” said Prague Community Hospital CEO Randy Simmons.

Simmons says that's below what it costs them to provide the care. However, losing BCBS, their third largest payer behind Medicare and Medicaid, isn't a great option either.

“It’s a difficult situation,” he said.

In a statement, BCBS said:

“As with all negotiations with hospital systems, BCBSOK is committed to protecting our members, especially from escalating costs, unnecessary charges and surprise balance bills, and to safeguarding our financial stability so we remain viable for our members.”

Patients like Rebecca worry that without a deal not only will she have to find somewhere else to get care, all her neighbors will too.

“If they close down the hospital then the emergency room closes too. And then if you have a kid that has a 4-wheeler accident that’s seven miles out now where is that kid going to go?”

After Oct 29, if a deal isn't reached, Prague Community Hospital will be out of network for all BCBS members. Hospitals in Drumright, Fairfax, and Haskell are also currently trying to negotiate a contract with BCBS.