Contract dispute between UMMC, BCBS of Mississippi a breaking point for some residents

Contract dispute between UMMC, BCBS of Mississippi a breaking point for some residents

Both companies are fighting over profits from patients who may just leave the state instead.

“Blue Cross Blue Shield is great insurance for us and for our family,” Zinda said. “It really was meeting our needs, then throwing a wrench in UMMC care is a giant pressure on us to say, OK, we can’t do this anymore’ … we are now seeing a total lack of healthcare in Mississippi on multiple levels. ”

Zinda says her friend group is relatively young — 30- and 40-somethings with new families that want to see a future in Mississippi, but feel like it’s no longer possible for them. In fact, soon after Zinda packed her bags and moved, her father decided to leave Mississippi as well.

Slade, who helped move Zinda to Chicago, is a mother and stepmother to 10 children, all of whom deal with a lot of medical issues. During the car ride, she said her husband had started looking for jobs elsewhere too.

“I know that we’re not probably the first people that are leaving because of this, and we won’t be the last,” Zinda said. “I see a lot of people in my age group talking about leaving.”

The ordeal isn’t just upending patients’ lives. There’s some evidence that patients are being used as bargaining chips.

For example, UMMC dropped BCBS months before open enrollment — when patients can shop for new insurance plans — leaving those insured by BCBS essentially stuck in limbo with insurance they can’t use at the hospital for months.

Amanda Starc, a health economist at the Kellogg School of Management at Northwestern University, says that timing was no accident.

“The hospital’s negotiating leverage comes from the fact that they’re essentially a monopoly,” Starc said. “What might [Blue Cross] enrollees do if they don’t have access to that monopoly hospital in their network? They’re going to switch insurance plans, and that puts pressure on Blue Cross Blue Shield.”

BCBS has quite a bit of leverage here, too. They’re the state’s largest insurer, holding 56% of the commercial health insurance market, according to 2021 estimates. Because so many Mississippians are in their plans, UMMC could lose a big patient base if a deal isn’t made.

Starc says these disputes and contractual issues are very common. BCBS of Illinois had a similar contract issue with a major health care system in 2021, with upwards of 50,000 patients impacted by a temporary loss of coverage, according to local reports. Earlier this year, a contract dispute between BCBS of Texas and the Memorial Hermann Health System — the largest for-profit health system in Southeast Texas forced nearly 200,000 people out of the network.

What’s rare about the dispute in Mississippi, Starc says, is that there is still no agreement — more than seven months later.

“Patients are actually being harmed,” Starc said. “Normally, we don’t let it get to the point where any patients are being harmed.”

Both UMMC and BSBS disagreed with how they were characterized in the story but refused to give details on why.

“We continue to be disappointed that our commercial Blue Cross-member patients do not have in-network access to UMMC hospitals, clinics, physicians and other providers,” a spokeswoman for UMMC said.

Similarly, Blue Cross declined to explain much about its position.

“Blue Cross & Blue Shield of Mississippi has been, and continues, in mediation with UMMC to reach a long-term solution which is in the best interest of Blue Cross Blue Shield Members and UMMC patients. We can make no further comment,” the insurer said in an email.

.

Be the first to comment

Leave a Reply

Your email address will not be published.


*