Contract Negotiation with Blue Cross Blue Shield of Georgia Put
Access to North Fulton Hospital at Risk
Roswell, GA (January 12, 2011) – Patients covered through Blue Cross Blue Shield of Georgia who receive care at North Fulton Hospital may find themselves out-of-network beginning February 1st. The potential change comes as North Fulton Hospital’s parent company, Tenet Health Systems, continues to try and negotiate an agreement with Anthem, the parent company of Blue Cross Blue Shield of Georgia (BCBSGA).
“Disagreements between health systems and managed care companies are all too common during contract negotiations,” says Deborah C. Keel, chief executive officer at North Fulton Hospital. “Unfortunately, when these disagreements are made public, it can often put patients and physicians in the middle.”
According to an online media source, BCBSGA’s parent company had over 17 public disagreements when negotiating contracts with health systems this past year. This number is significantly higher than other managed care companies including Aetna and Cigna.
“We have been trying to negotiate new contracts with BCBSGA since July 2011, but received no response until late December,” said Keel. “Since providing quality care and treatment to patients within the North Fulton community is our top priority, it is disappointing that we could not get BCBSGA to engage earlier to avoid this potential disruption in service.”
As the cost of providing healthcare within the nation increases, Blue Cross Blue Shield continues to raise premiums in Georgia and nationwide. Yet, hospitals and physicians are often not offered comparable rate increases.
Tenet requests rate increases equal to BCBSGA’s parent company’s 2011 national average premium increase to employers and their members. In addition, Tenet claims that if BCBSGA lowers their average premium increases year over year, they will reduce its expectations to match the reduced average premium increase.
If an agreement is not reached between Tenet and Anthem, BCBSGA members will be forced to pay out-of-network rates with higher co-pays when they use any of the Tenet hospitals within metro Atlanta, which includes North Fulton Hospital, Atlanta Medical Center, South Fulton Medical Center, Spalding Regional Medical Center and Sylvan Grove Hospital.
“Patients need access to their community hospitals, especially when critical services are provided such as the Level II trauma center and Primary Stroke Center located at North Fulton Hospital. We recognize that this is very disruptive for our patients, physicians, employees and the community,” said Keel. “We have been able to resolve all contract negotiations with other plans without a disruption in service; however, BCBSGA's parent company’s position has made it nearly impossible for us to make any real progress toward resolution.”
Individuals who are covered by Blue Cross Blue Shield of Georgia may vocalize their concerns by calling Brian Fetherston, Regional Vice President of Sales for Blue Cross and Blue Shield of Georgia, at 404-682-9211 or email brian.fetherston@bcbsga.com. Additional information can be found regarding the negotiations by logging onto www.GaTenetAnthemIssue.com.