Where We Stand
Employers and members are always asking us to help lower costs. Their need for affordability became more urgent during the pandemic and as inflation rose. We’re actively negotiating new contracts – or ending contracts – with providers who are being paid much higher rates than their peers, including the Methodist Le Bonheur Healthcare system.
Our Methodist Le Bonheur Healthcare system rates were significantly higher than our average rates for other facilities in the Memphis area – and in the case of Methodist Le Bonheur Children’s Hospital, their rates were the highest of any children’s hospital in Tennessee by far. For the majority of these facilities, we offered Methodist Le Bonheur Healthcare new contracts with lower, fair-market rates that would enable us to lower premiums significantly for BlueCross members.
We know network changes are difficult, so we make them only when necessary. This will help us keep coverage affordable in the Memphis market and better manage the cost of care for our Memphis- area members.
Since an agreement has not been reached, Methodist Le Bonheur Healthcare facilities have been removed from several BlueCross networks, including Blue Network PSM, BlueCare TennesseeSM, TennCare Select, CoverKidsSM and the Dual Special Needs Plan (D-SNP) effective Jan. 1, 2023. Impacted facilities include:
- Methodist University Hospital
- Methodist Healthcare – Germantown
- Methodist Healthcare – North Hospital
- Methodist Healthcare – Olive Branch Hospital
- Methodist Healthcare – South Hospital
- Methodist Blood and Marrow Transplant Center
- Methodist Comprehensive Breast Center – Germantown and Midtown locations
- Methodist Le Bonheur Children’s Hospital
- Methodist Le Bonheur Germantown
- Methodist Le Bonheur Germantown Surgery Center
- Wolf River Surgery Center (effective Oct. 23, 2023)
The following facilities have been removed from Blue Network SSM:
- Methodist Le Bonheur Children’s Hospital
- Methodist Le Bonheur Germantown
While we hope to come to an agreement that would bring Methodist Le Bonheur Children’s Hospital and Le Bonheur Germantown back to both Network P and Network S, we have removed the following facilities from Network S permanently as of Jan. 1, 2023:
- Methodist Alliance Home Care Services
- Methodist Alliance Home Medical Equipment
- Methodist Healthcare Minor Medical Center (Cordova, Hacks Cross, Midtown Memphis, Olive Branch)
- Methodist Le Bonheur Germantown Surgery Center
- Wolf River Surgery Center (effective Oct. 23, 2023)
- Methodist Alliance Hospice (effective Oct. 31, 2023)
Medicare Advantage members are not impacted by this dispute.
Please check back for additional updates.