JACKSONVILLE, Fla. – The deadline for Florida Blue and Baptist Health to come to terms on a new contract agreement is Monday night.
If both parties fail to reach an agreement before Oct. 1, Baptist Health will be considered out-of-network for some 600,000 Florida Blue customers across the region.
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Baptist Health released an update Friday on the ongoing battle with the insurance company.
According to Baptist Health, Florida Blue “made it clear” that it is not interested in negotiating but “requested a 30-day extension” to the current contract.
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.
“We cannot see any wisdom in an extension given Florida Blue’s refusal to compromise, yet we remain ready to negotiate any time and any day for a fair agreement by the original deadline,” the hospital said in a statement.
Read the full statement from Baptist Health below:
For the past eight months, Baptist Health has consistently engaged in good-faith negotiations with Florida Blue. With just days left until our current contract expires at midnight on September 30th, we had expected a reasonable response to our most recent offer. Instead, today Florida Blue has made it clear that they are finished negotiating but in the next breath requested a 30-day extension to our current contract. We cannot see any wisdom in an extension given Florida Blue’s refusal to compromise, yet we remain ready to negotiate any time and any day for a fair agreement by the original deadline. We seek an agreement that ensures we can continue providing the vital services our community depends on, both now and in the future.
Baptist Health
Florida Blue countered Baptist Health’s latest statement by stating that the reason for the 30-day extension was to continue negotiating the contract.
The health insurance company said the latest offer it received from Baptist Health adds up to a 58% rate increase over the next five years, with annual increases that average nearly 10%.
Florida Blue said patients will be financially impacted if they agree to Baptist’s proposal.
“We have also offered to continue meeting with Baptist Health over the weekend to reach a resolution,” the insurer said in a statement Friday evening.
The hospital refused both offers, according to Florida Blue.
Florida Blue also provided the following updates on the contractual negotiations.
The insurer said it asked for a separate agreement for Wolfson Children’s Hospital, but Baptist Health was “standing firm on its “$1 billion demand” and refused the offer that Florida Blue said was “exceptionally generous and would substantially increase reimbursement for care provided at Wolfson.”
Florida Blue said the hospital also made its “demands at a time when 91% of Jacksonville residents are concerned about rising health care costs,” according to a new Harris Poll survey.
The insurer also specified certain negotiating tactics that it believed would put Wolfson doctors and providers in an “impossible position” to choose to travel with patients who would no longer be able to receive local elective care under Baptist Health’s proposed contract or decline to provide them care, according to Florida Blue.
Some Florida Blue Members may qualify for Continuity of Care coverage if a deal doesn’t pan out. The continuing coverage only applies to members undergoing active treatment for serious and complex conditions, and for those who are pregnant, for a short period of time.
Otherwise, members who want to continue seeing Baptist doctors will have to pay out-of-pocket. Many patients have already been offered the option to “self-pay” for future appointments.
Jennifer Trednick has four autoimmune conditions and has been seeing the same doctors for years to manage her symptoms. She tells News4JAX that a disruption in care could impact her lifestyle.
“At this point, all of my conditions are very well managed. I’m able to lead an active life, but beginning over and knowing that 600,000 patients, just like me are going to be racing to doctors, I don’t even know if I’ll be able to get an appointment with a new team of physicians,” Trednick said. “I was assured that I could have a continuity of care, but that’s only for 90 days, and after that, I’ll be paying out of pocket.”
In terms of how long Continuity of Care lasts, it depends on your coverage.
- For PPO members, COC applies for 3 months (90 days) after the contract date.
- For HMO members, COC applies for 6 months (180 days) after the contract date.
The same applies to Medicare members. If you’re eligible for Continuity of care under Florida Law, providers should not cancel any future appointments. Your doctor should continue to receive payment for authorized services, even if they are not in the plan’s network and prescriptions must be honored.
As a patient, Trednick said she feels left behind by the two parties as the 11:59 p.m. Monday deadline looms.
“It’s been very concerning from day one, I feel like this is a high-stakes poker match, and unfortunately, the chips are the patients. I especially feel for patients that are undergoing cancer treatments, for women that are pregnant, where they could have an end to their health care,” Trednick said. “The ideal solution would be these two large, local Jacksonville companies to come to an agreement for the benefit of their patients.”
For continuity of care eligibility questions or to understand your individual benefits, contact Florida Blue’s Customer Service team at 1 (800) 352-2583.
Florida Blue intends to continue to pay for claims for services performed at Wolfson Children’s Hospital as Wolfson is the only pediatric hospital in the region.
For more information on what other major insurers Baptist Health accepts, click here.
Patients can also find answers to their questions at baptistjax.com/florida-blue and at floridablue.com/negotiation/baptisthealthjax.