Mississippi’s Largest Hospital, Insurer Ends Contract Dispute

Mississippi’s largest private insurer and its largest hospital have entered into a new contract, which means patients covered by Blue Cross & Blue Shield of Mississippi can once again seek care at the University of Mississippi Medical Center at rates within the network.

The insurer and the hospital announced Friday that the medical center was back in network as of Thursday. The announcement, in a three-paragraph statement, left it unanswered whether the hospital or the insurer won their fight over how much the medical center should be paid.

“Blue Cross and UMMC remain focused on their missions of serving the health care needs of Mississippians,” the statement said. “The terms of the contracts are confidential.”

The medical center has long argued that Blue Cross doesn’t pay it enough compared to similar hospitals in other states. The medical center is Mississippi’s only provider of a few medical specialties, including the state’s only top-tier trauma center and its most capable neonatal intensive care unit. Other hospitals across much of the state routinely transfer patients with the most complex conditions to the main medical center complex in Jackson.

However, Blue Cross has said that paying the medical center the fees it demanded would cause clients’ premiums to rise.

The hospital and the insurer have also discussed how Blue Cross pays hospitals for quality results.

The year-long dispute flared up again on April 1, when the medical center parted ways with Blue Cross. Patients covered by the insurer could still see providers affiliated with the medical center, but most faced higher costs. Some patients reported putting off surgeries, while others traveled out of state.

Dr. Alan Jones, associate vice chancellor for clinical affairs at the medical center, urged medical center faculty to help restore relationships with Blue Cross policyholders, according to a memo obtained by the Northeast Mississippi Daily Journal.

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

Republican Insurance Commissioner Mike Chaney said in a statement that he was grateful the two entities had overcome their differences and returned affordable health care to 750,000 policyholders.

“It is my sincere hope that UMMC and BCBSMS now move forward in a collaborative relationship to provide innovative, accessible and affordable health care in our state while putting patients and members first,” Chaney said.

Both sides fought for the public’s favor with advertisements and billboards. In July, Blue Cross & Blue Shield sued three medical center officials for defamation, including vice chancellor and dean of the medical school Louann Woodward Jones and spokesman Marc Rolph. The insurer said her public statements made it appear that the insurer removed the medical center from its network when the insurer said the medical center was the one that finalized agreements with the insurer.

It was not immediately clear if the insurer would drop the lawsuit.

The dispute could lead to further regulation of insurers. Chaney has proposed that lawmakers block contracts between insurance companies and health care providers from being canceled outside of a 90-day window before an open enrollment period.

The hospital also lost $50 million in federal COVID-19 relief funds it planned to use for capital improvements at its adult hospital and operating rooms after Republican Gov. Tate Reeves vetoed the allocation in April. Reeves said at the time that the state should not “further subsidize UMMC’s operations to the detriment of competitors” when the hospital was “willingly” turning away Blue Cross patients.

This story was originally published December 16, 2022 21:21.

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