Thousands of University of Utah Health patients insured by Regence BlueCross BlueShield will be forced to find a new provider or pay out-of-network costs for care if the two groups clashing over increased health care costs can’t make a deal before the end of the month.
Even if they reach a new deal, their impasse has left tens of thousands of Utahns distressed over the possibility of significant policy changes.
The organizations, which have worked with each other since the University of Utah Hospital was founded in 1965, have been negotiating a new contract since last year that would keep the U. Health system within Regence’s network, according to a blog post on the insurance provider’s website.
“Unfortunately, Regence and University of Utah Health have been unable to agree on an increase in what we pay them for care that will not significantly increase premiums,” the blog post read. A Regence spokesperson declined to answer additional questions and referred The Salt Lake Tribune to the blog post.
U. Health said in a statement provided Wednesday, “We are confident that a resolution with Regence can be reached that prioritizes the health and well-being of our patients, our teams and our community.”
The organizations have until June 30 to finalize a contract. If not, most patients using Regence will either pay out-of-network costs to continue treatment with their U. Health provider, or they will need to find someone else at a different health system.
Some patients, including those who are pregnant, have some chronic conditions or already have a non-elective surgery scheduled, may be able to continue care with U. Health “for a limited time after the contract ends,” Regence said.
U. Health treats between 70,000 to 80,000 patients insured with Regence — including those insured through a Medicare Advantage plan — who are not University of Utah employees, spokesperson Kathy Wilets said. They treat an additional 50,000 who are U. employees, and Wilets said the U. “has taken steps to provide care to these patients as though they are still ‘in network.’”
Any changes to U. Health’s in-network status would not impact Medicare Supplement (Medigap) members “because they can see any provider that accepts Medicare,” Regence said in its blog post.
Connie Millecam, 80, lives in Holladay and has been using Regence insurance for about 15 years, since she started a Medicare Advantage plan. Millecam said she has a pacemaker and a heart murmur, and recently her heartbeat has gotten increasingly irregular.
She has been stressed since receiving a letter earlier this month from Regence’s director of Medicare operations, David Dodge, announcing that U. Health may no longer be an in-network provider. So she called Regence for information, said she was told there are other providers who could offer the care she needs.
But Millecam trusts her U. Health doctor, and thinks the health care system is “world class.”
“I do not want to go to St. Mark’s (Hospital) and I don’t want to go to IHC,” Millecam said. “My doctor is at the University of Utah.”
According to Dodge’s May 22 letter, the insurance company is “committed” to reaching a compromise.
“Regence regularly works with providers across our state on network contract to help manage quality medical care at an affordable cost for our members,” Dodge wrote. “We also strongly believe doctors, nurses and other providers should be fairly compensated for care — and that members should not be put in the middle of standard network negotiations.”
“Unfortunately,” he continued, “Regence and University of Utah Health have been unable to agree on a sustainable rate increase.”
Now, Millecam is wondering what to do about her pacemaker. She is due for a new one this fall.
Regence asked any members with questions about continuing their care at U. Health to call the number on the back of their member ID card.
Dodge’s letter listed other providers in the Salt Lake City area who remain in-network, including Foothill Family Clinic, Granger Medical Clinic, Holy Cross Health, Intermountain Health and MountainStar Healthcare’s physicians network.
In a post to patients on its website, U. Health said, “We understand this news is frustrating and potentially confusing. We regret the disruption it may cause for you and your family. We will work closely with you to ensure that your health care is appropriately transitioned if that becomes necessary.”