Skip to main content
Clear icon
72º

Thousands of patients risk going out of network if Florida Blue, Baptist Health fail to reach agreement soon

Current contract expires Sept. 30

Florida Blue Insurance is undergoing contract negotiations with Baptist Health. (Copyright 2024 by WJXT News4JAX - All rights reserved.)

JACKSONVILLE, Fla. – Thousands of Florida patients could find themselves out-of-network if Florida Blue and Baptist Health don’t reach a contract agreement before the Sept. 30 deadline.

The two sides have been at it since February but have not agreed to a deal.

Recommended Videos



RELATED | Florida Blue, Baptist Health have 1 month to negotiate new contract

On Friday, Florida Blue said it had introduced a new multi-year proposal that would significantly increase Baptist’s rates.

However, Florida Blue said, “This is not enough for Baptist,” and added that Baptist is seeking a cumulative 60% increase in rates over the next five years.

Florida Blue also said that it reached out to Baptist leaders last week about coverage for services at Wolfson Children’s Hospital.

The health insurance company said if a new contract is not approved by Oct. 1, it will still pay claims for services at Wolfson.

Read the full statement from Florida Blue below.

“It is Florida Blue’s responsibility to protect our members from out-of-control and unnecessary cost increases which they cannot afford. Baptist Health’s latest demands remain outrageous and unacceptable. Their proposed rate increase – over $1 billion in additional reimbursements – would unfairly burden our members, and this community.

Our proposal strikes a fair balance, meeting Baptist’s needs while protecting our members’ interests, and preserving their access to the doctors we all respect. It is our members’ money is at stake here, so Florida Blue must stand firm in our promise to deliver affordable care to them.”

Darnell Smith, Florida Blue North Florida Market President

Baptist Health responded to Florida Blue’s statement, and called the claim that they’re asking for a $1 billion increase that would result in higher healthcare costs “factually untrue,” and said that the increase they proposed amounts to “less than a third of the total they have publicly claimed.”

Read the full statement from Baptist Health below.

“We continue to negotiate with Florida Blue for a new contract and will work hard toward that goal through the end of the month when our current contract expires. One of the challenges we are dealing with is the lack of honesty in Florida Blue’s public statements and the chilling effect that has on our relationship and trust.

Florida Blue continues to tell people that we are asking for payment increases that are simply untrue – what we are asking for is fair and reasonable. The reasonableness of our real ask, not what Florida Blue claims, is proven by two facts:

- One, what we are asking for and what we need is less than what Florida Blue already pays health systems in other parts of the state. For example, Wolfson Children’s Hospital receives approximately two-thirds of the compensation that Florida Blue provides to similar children’s hospitals in Florida.

- Two, what we are asking for and what we need is significantly less than what every other health plan pays us and what they pay other systems around the state.

This is all validated by publicly available transparency data provided by the health plans themselves.

The one thing we seem to be aligned with Florida Blue right now is the need for access for people who need our help. People can continue to access our emergency departments without financial penalty, and we will treat every single patient covered by Continuity of Care. That requires Florida Blue approval, and there is no reason for them to deny that option to anyone. Beyond that, the solution to access for Florida Blue members is a contract, nothing else. We will not put people in a situation where they don’t know what they owe out of pocket or receive surprise bills because we simply do not have confidence that Florida Blue will treat us fairly or pay accurately. Out-of-network is not a solution for our patients or Baptist Health and Wolfson Children’s, even if that’s what Florida Blue seems to want at this point.”

Baptist Health spokesperson

People with Florida Blue insurance, and who use Baptist Health services, will want to check their mailbox. Potentially impacted residents should have gotten a letter telling them about contract renegotiations that could impact their health coverage.

Patients can find answers to their questions at baptistjax.com/florida-blue and at floridablue.com/negotiation/baptisthealthjax.


About the Author
Marcela Camargo headshot

Marcela joined News4JAX in 2023. She grew up in Mexico and eventually moved to California to pursue her dream of becoming a journalist. Now, she is a proud San Diego State University alumna who has many years of experience in TV and digital journalism.

Loading...

Recommended Videos