JACKSONVILLE, Fla. – Thousands of Florida Blue customers are in limbo as they wait to learn if Baptist Health Systems will remain in-network for their medical bills.
In just seven days, Florida Blue’s insurance contract with Baptist Health will expire.
The parties are still undergoing contract negotiations and if they can’t agree on an agreement before October 1, Baptist Health will be considered out-of-network for some 600,000 Florida Blue Customers across the region.
The contract negotiations impact Florida Blue customers who utilize Baptist Health facilities for their health needs. Those getting specialized care at Wolfson Children’s Hospital and the MD Anderson Cancer Center will also need to pay close attention to these contract negotiations.
The issue all comes down to money.
Contracts between hospitals and insurers typically determine the prices that insurers pay to hospitals for various medical services.
Baptist Health maintains that they’ve taken on too many costs with workforce shortages, record inflation, and rising costs of drugs and supplies all coming into play.
”In the last few years, our health system has served as a ‘shock absorber’ for our community, providing the majority of care throughout the pandemic and weathering the challenging conditions that have followed,” Dr. Timothy Groover said in a video statement to patients posted online. Groover is Baptist Health Systems Chief Medical Officer.
Meanwhile, Florida Blue officials say patients will be financially impacted if they agree to Baptist’s proposal. A spokesperson tells News4JAX their latest demands represent more than $1 billion in new costs.
“Unfortunately, your healthcare costs will skyrocket if Florida Blue agrees to the outrageous demands that Baptist Health Jacksonville is making during our current negotiations,” Darnell Smith said in recent a video statement, President, Florida Blue North Florida. “Our current offer is fair, market competitive, and generous.”
A message to patients on BaptistJax.org indicates that the parties are making progress toward reaching an agreement. Baptist also issued a statement to News4JAX on Monday:
“People want to know why we haven’t yet reached an agreement. The problem is our starting point. We have been underpaid by Florida Blue for years, with zero rate increases to our physicians since 2016. The gap is compounding every year. We don’t want to be in this conflict, but we must make up ground so we can continue to remain a viable health care option for our community. We need Florida Blue to step up and bring us closer to what similar health systems are paid, versus stepping aside and blaming their annual increase on the negotiation. That’s their choice. Not ours.”
Florida Blue said the latest offer they received from Baptist Health adds up to a 58% increase in rates over the next five years, with annual increases that average nearly 10%.
Randy Wyse, the Executive Director of the Jacksonville Police Officers and Firefighters Health Insurance Trust, said the importance of Florida Blue and Baptist Health agreeing on a new contract is weighing on our local first responders and their families.
Florida Blue is the designated health insurance provider for city employees, first responders, and Duval County Public School staff.
Wyse is putting pressure on the two companies to get a deal done so they don’t lose their coverage.
“You know, firefighters have a real high chance of getting cancer due to our jobs and there’s even some police officers that are dealing with that, that use utilize MD Anderson. Their future is uncertain,” Wyse said. “Police officers and firefighters are never going to turn their backs on the citizens of Jacksonville when they call for help. We’re asking that these parties don’t turn their backs on us.”
Florida Blue intends to continue to pay for claims for services performed at Wolfson Children’s Hospital and for pregnant women as part of what’s called Continuity of Care for those who are in active treatment.
Emergency Room visits and certain other services would still be considered in-network after Sept. 30.
However, MD Anderson cancer patients will be considered out-of-network if the parties don’t finalize a new contract by October.
If members have questions about these possible network changes, they can call the number on the back of their membership card or visit a Florida Blue center in person for help.
For more information on what other major insurers Baptist Health accepts, click here.