It’s All About Reimbursement Increases [PHIL-OSOPHY]
The flustered caller to my show started by describing the worry and anxiety his 82-year-old mother was going through since hearing about the public dispute between Southcoast Health and Blue Cross Blue Shield of Massachusetts.
She, like many of us, has no idea how insurance companies, hospitals and doctors figure out the costs of delivering quality healthcare. All she understands is she likes her primary care physician and dislikes any changes to a routine she's familiar with.
I wish American healthcare was that simple.
If you haven't heard by now, Southcoast Health has said it will put an end to its contract with Blue Cross Blue Shield of Massachusetts unless it receives a pay increase. Negotiations between the health care provider and the insurer have grown argumentative and choleric with Southcoast Health telling Blue Cross Blue Shield that it will leave the insurance company's network as of January 1, 2020, if not resolved.
A drastic move like that would affect not only the caller's mother but between 60,000 to 80,000 Southcoast region patients who see one of the 86 primary care physicians or 260 specialists around here.
Southcoast says it's among the lowest-paid providers in Massachusetts, but Blue Cross Blue Shield says the payments are in line with New England Baptist, Boston Medical Center, Steward Holy Family, Plymouth Medical Center and Beth Israel.
The caller's elderly mother has no idea about these matters. She just doesn't want to pay more money or travel to Boston to get the healthcare she's happy with right here.
This threat to terminate Southcoast Health's contract with Blue Cross Blue Shield has happened before, in 2010, when the two parties came this close to ending their relationship. And although these contract negotiations have grown contentious, positive settlements have been reached before, but only in the last moments.
Phil Paleologos is the host of The Phil Paleologos Show on 1420 WBSM New Bedford. He can be heard weekdays from 6 a.m. to 10 a.m. Contact him at email@example.com and follow him on Twitter @PhilPaleologos. The opinions expressed in this commentary are solely those of the author.