UMMC, contract dispute ends Blue Cross

Mississippi’s largest private insurer and its largest hospital have secured a new policy, meaning patients covered by Blue Cross & Blue Shield of Mississippi can continue to seek care at University of Mississippi Medical Center for in-network rates.

The insurer and hospital announced Friday that the medical center has returned to in-network operations as of Thursday. It was announced, in a three-paragraph statement, that it remained unanswered whether the hospital or insurance company was at the forefront of their fight over how much the medical center should be paid.

“Blue Cross and UMMC remain focused on their mission to serve the health care needs of Mississippians,” the statement said. “The terms of the contract are confidential.”

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The medical center has long argued that Blue Cross pays less than similar hospitals in other states. The medical center is Mississippi’s only provider of several medical specialties, including the state’s only top-level trauma center and the most capable neonatal intensive care unit. Other hospitals in much of the state routinely transfer patients with the most complex medical conditions to the premier medical center complex in Jackson.

However, Blue Cross has said that paying the medical center the rate it claims will drive up a customer’s premium.

Hospitals and insurance companies have also argued over how Blue Cross pays hospitals for quality outcomes.

The years-long dispute erupted again on April 1, when the medical center parted ways with Blue Cross. Patients covered by the insurance company can still see medical center providers, but most face higher costs. Some patients reported postponing surgery, while others traveled out of state.

Dr. Alan Jones, vice-chancellor for clinical affairs at the medical center, has called on the medical center’s faculty to help re-establish relationships with Blue Cross policyholders, according to a statement. memo of the Northeast Mississippi Daily.

“We understand that the past few months have been difficult, and I appreciate the work that our clinical departments, care teams and support staff have done to support affected patients,” the report said. newspaper reports.

State Insurance Commissioner Mike Chaney said in a statement that he was grateful the two organizations overcame their differences and returned affordable health care to 750,000 policyholders.

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“I sincerely hope that UMMC and [Blue Cross and Blue Shield of Mississippi] will now forge a partnership to deliver innovative, accessible, and affordable health care in our State, and will place patients and policyholders as their top priority,” said Chaney.

Both sides vie for public support with advertisements and billboards. In July, Blue Cross & Blue Shield sued three medical center officials for defamation, including Vice Chancellor and Dean of Medicine Louann Woodward, Jones and spokesman Marc Rolph. The insurer said its public statements made it appear the insurer had removed the medical center from its network when the insurer said the medical center itself had terminated the agreement. with the insurance company.

It is unclear whether the insurance company will drop the lawsuit.

Disputes can lead to increased regulation by insurance companies. Chaney has proposed that lawmakers prevent contracts between insurers and healthcare providers from being canceled beyond the 90-day deadline before the open enrollment period.

The hospital also lost $50 million in federal COVID-19 relief funds that it plans to use to capitalize on adult hospitals and operating rooms after Republican Governor Tate Reeves covered decide the allocation in April. Reeves said at the time that the state should not “subsidize UMMC operations to the detriment of competitors” when the hospital is “willing” to turn away Blue Cross patients.


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