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Health coverage for thousands of Mississippians in question as UMMC and Blue Cross negotiate contract



University of Mississippi Medical Center

Thousands of patients of Mississippi’s largest hospital and its clinics could be on the hook for higher out-of-pocket costs if the University of Mississippi Medical Center and Blue Cross & Blue Shield of Mississippi do not agree on a new contract by March 31.

The contract dispute dates back to 2018 but was temporarily resolved when an agreement was reached then between the two entities. UMMC, the state’s largest health care provider, wants Blue Cross, the state’s largest insurer, to pay higher reimbursement rates for medical services provided. BCBS has balked at that request.

The contracts negotiated between insurers and providers include massive discounts for the providers in their networks. If an agreement cannot be reached before March 31 and UMMC is forced out of the BCBS network, thousands of patients with BCBS insurance plans would have to pay the hospital’s inflated “chargemaster” prices or find health care elsewhere.

This week, UMMC officials sent a letter to each of its patients with commercial BCBS plans, alerting them to how their coverage could be affected by the outcome of the ongoing negotiations.

“Our negotiations with Blue Cross continue and we are hopeful that a new contract can be agreed upon before the current agreement ends,” Dr. LouAnn Woodward, UMMC vice chancellor for health affairs, said in a statement to Mississippi Today on Friday. “It’s a top priority that all Mississippians have uninterrupted access to the physicians and other services provided by the state’s only academic medical center and no patients experience disruption to their trusted UMMC care.”

Blue Cross & Blue Shield of Mississippi officials did not respond to a request for comment on Friday.

Even if a new agreement isn’t reached, those enrolled in the Mississippi State and School Employees’ Health Insurance Plan would not be affected. Though that plan is administered through BCBS, the current negotiations only affect the insurer’s commercial insurance plans.

Still, thousands of Mississippians would be affected because BCBS is the largest private health insurance provider in the state, with a 17.56% market share, according to data from the Mississippi Department of Insurance. Those patients would have to find a new in-network provider or face higher costs. Many wouldn’t have a choice if they were to need emergency care at UMMC, or required any of the specialized services only exclusively by the medical center.

These services include Mississippi’s only Level 1 trauma center, Level IV neonatal intensive care unit and children’s hospital, among other critical care services.

This isn’t the first time UMMC and BCBS have battled over contract negotiations. UMMC pursued higher reimbursement rates before their original 28-year-old contract with BCBS was set to expire on June 30, 2018.

That negotiation period dragged on for months and passed the expiration date, though patients with BCBS plans were still treated as being in-network while the two parties haggled.

A new contract was eventually signed in August 2018. That contract is at the center of the current dispute.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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