Blue Cross Blue Shield/Catholic Health Initiatives Prepare as Negotiation Deadline Nears


Time is running out on negotiations between two health care giants in the state.

If Blue Cross Blue Shield and Catholic Health Initiatives don’t come to an agreement by the end of August more than 140,000 Nebraskans could be paying more for treatment – that includes patients using St. Francis Medical Center in Grand Island and Good Samaritan Hospital in Kearney.

BCBS kicked off public meetings Wednesday to address questions and concerns.

Tensions were high as they laid out their negotiations with CHI.

The problem, BCBS says, is with Omaha hospitals and physicians charging 10 to 30 percent more than other providers.

CHI says BCBS maintains an outdated fee-for-service model.

"We don't have a dispute here with Grand Island and with St. Francis. We actually have an agreement on the rates but CHI is unwilling to break those up," said Lee Handke, senior vice president of BCBS Health Network Services.

Their first public meeting was standing-room only. Among those attending were representatives from Grand Island Public Schools and the city of Grand Island.

"Obviously we're hopeful that both parties can come together and resolve this issue quickly," said Brenda Sutherland, director of Human Resources for the city.

Sutherland said the city alone has about 500 full time employees that may be impacted.

"It's good for people to become informed on this topic," she said.

Here's what Blue Cross Blue Shield has to say: If negotiations fall through certain conditions will still be covered under what they call continuity of care. Patients receiving cancer or AIDS treatment, for example, will just have to fill out a form.

Emergency care will also be covered.

Outside of Omaha, visits to your physician will not be impacted.

“For the hospital care you can seek a non-CHI facility. Now, we know in Grand Island there's only one and so we're still hopeful that CHI will agree to sign an agreement for them and let them be back in network as of September 1," said Handke.

Handke says as customers start to shop around more for health care, these types of negotiations will likely change.

"I think you'll start to see more transparent communication to individuals about there are cost differences, and at BCBS, we are taking a stand on behalf of our customers to make sure those costs are reasonable," he said.

CHI said they’re also trying to keep costs down, while improving patient care.

In a statement to NTV, Saint Francis President Dan McElligott said, “We remain open to working with Blue Cross to come to an agreement, but unfortunately Blue Cross isn’t moving or showing any interest in moving in their negotiations. As a result we are making preparations to be out of network.

“Caring for our community has always been our number one priority and we are working to ensure our patients experience as little disruption in their care as possible once we are out of network. Even as we make these plans, our latest proposal is still on the table for Blue Cross to consider. We proposed rate cuts and freezes, and have asked for an extension to resolve this issue, but Blue Cross has refused. It’s unfortunate that Blue Cross is interfering in people’s decisions on where they seek care and effectively forcing our patients in Grand Island to travel a great distance to the next closest hospital for care. We wanted nothing more than to see this issue resolved quickly and we know this change may create anxiety for our patients and others.

“Regardless of the outcome of our Blue Cross negotiations, emergency care is always covered at in-network benefit levels. You should always go to the closest emergency room when in need.”

St. Francis plans to have a similar meeting for human resource representatives on Friday.

Blue Cross Blue Shield will be having more public meetings, all starting at 6:00 p.m.:
Aug. 14: Omaha, Embassy Suites, 555 South 10th Street.
Aug. 18: Lincoln, Embassy Suites, 1040 P St.
Aug. 19: Columbus, Platte County Ag Park, 822 15th St.
Aug. 20: Kearney, Younes Conference Center, 416 W. Talmadge Road
Aug. 21: Elkhorn area, location to be determined

For more information from Blue Cross Blue Shield, click here.

For more information from Catholic Health Initiatives, click here or call (800) 418-7212.