University of Mississippi Medical Center, Blue Cross end 9-month contract dispute

2022-12-19

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来源: FierceHealthcare

Since 2018, the University of Mississippi Medical Center has maintained Blue Cross Blue Shield of Mississippi should pay the hospital system larger reimbursements for care its hospitals provide, according to media reports.

Mississippi’s largest private insurer and the state’s only Tier 1 medical facility reached a new contract after a nine-month dispute over reimbursement rates.

The University of Mississippi Medical Center (UMMC) and Blue Cross Blue Shield of Mississippi agreed upon a new contract, and the medical center had returned to being in-network of last Thursday, the organizations announced.

All UMMC facilities, physicians and other individual professional providers are fully participating network providers for all Blue Cross Blue Shield commercial health plans, including the Federal Employee Plan and BCBS plans from other states, according to a three-paragraph statement.

"Blue Cross and UMMC remain focused on their missions of serving Mississippians’ health care needs," the organizations said.

The organizations did not reveal details of the contracts, saying the agreement is "confidential."

A dispute began in late March as the medical center demanded higher reimbursement rates for the unique care provided as a university hospital. But Blue Cross denied their original bid, Mississippi Public Broadcasting reported.

State Insurance Commissioner Mike Chaney says 750,000 BCBS enrollees were left without coverage at the medical center during the nine-month dispute.

"While this matter drug on far too long and resulted in undue hardship and disregard for many patients and over 750,000 BCBS enrollees, I am thankful that the parties were able to overcome their differences and find common ground," Chaney said in a statement. "UMMC is in the process of informing its patients that the hospital and Methodist Rehab are back in network. Children and patients in need of specialty medical now have access to UMMC."

Since 2018, UMMC has maintained that the insurance giant should pay the hospital system larger reimbursements for care its hospitals provide, bringing UMMC’s compensation more in line with other academic medical centers in nearby states, the Mississippi Free Press reported.

The dispute escalated April 1 when the medical center parted ways with Blue Cross.

Negotiations previously stalled over the summer as BCBS and UMMC disagreed over reimbursement rates, leaving many insured Mississippians without affordable access to care at the state’s largest medical complex, according to media reports.

Back in July, the Mississippi State Medical Association spoke up in favor of UMMC, castigating the insurance giant’s Mississippi branch for “corporate greed," the Mississippi Free Press reported.

“The Mississippi State Medical Association (MSMA) has long fought for physicians and most importantly, the patients in our great state. However, Blue Cross Blue Shield of Mississippi’s corporate greed on multiple issues, including prior authorizations, access to care, reimbursement cuts, and telemedicine has made that fight increasingly difficult,” the statement read in part, the publication reported.

Alan Jones, M.D., UMMC associate vice chancellor for clinical affairs and professor of emergency medicine, told the Mississippi Free Press in March that UMMC was an academic and medical anchor for the state and thus required a different reimbursement rate than other hospitals in Mississippi. “Just like the other academic medical centers in our region, (we) demand a different reimbursement rate than other hospitals,” Jones said.

Previously, Blue Cross Corporate Communications Manager Cayla Mangrum told the Mississippi Free Press that UMMC’s demands overvalue its place in the healthcare ecosystem of the region. “As to UMMC’s claim to be paid more as an academic medical center, UMMC is comparing themselves to institutions they are not,” Mangrum wrote. “For example, UMMC’s publicly reported quality scores are lower than other nearby academic medical centers where our Members frequently seek services.”