Why Methodist Le Bonheur should negotiate lower health care rates with Blue Cross | Opinion

BlueCross BlueShield Latest Updates

Kevin Woods, Commercial Appeal, December 5, 2022

If Methodist does not agree to more reasonable rates, most Methodist Le Bonheur Healthcare facilities will no longer participate in BlueCross networks as of Jan. 1, 2023.

It’s impossible to ignore the difficulties families across Tennessee are facing due to historic inflation. It’s also no secret that health care costs continue to skyrocket. At BlueCross, we know people need relief.

Our responsibility is to secure access to affordable care and help manage rapidly rising costs for the 3.3 million members and thousands of Tennessee businesses that depend on our coverage.

That’s why we’ve been actively negotiating new contracts with several providers and hospital systems for the past several months — both in the Memphis area and around the state. This includes Methodist Le Bonheur Healthcare.

Why there needs to be a new contract

Methodist Le Bonheur Healthcare charges us significantly higher rates than other facilities in the Memphis area. In the case of Methodist Le Bonheur Children’s Hospital, they charge the highest of any children’s hospital in the state by far. 

We value the care the Methodist system provides, and we hope to reach new agreements. However, if Methodist does not agree to more reasonable rates, most Methodist Le Bonheur Healthcare facilities will no longer participate in BlueCross networks as of Jan. 1, 2023. 

These changes are necessary to help us keep coverage affordable in the Memphis market and better manage the cost of care for our Memphis-area members. 

We’re sharing this news now because we want our members to know what’s happening and understand their options.

What if a contract doesn’t happen?

BlueCross members will continue to have access to quality health care from other Memphis-area providers and through our preferred partnership with the Baptist Memorial Health Care system.  It’s important to note that this renegotiation is only with Methodist facilities – this does not impact Methodist Medical Group primary care or specialist practices. A list of impacted facilities can be found at bcbstnetworkupdates.com.  

We understand the uncertainty that can come along with changes to a provider-patient relationship. Our customer care representatives are available now to answer any questions affected members might have. Members simply need to call the phone number on the back of their member ID cards to be connected with a BlueCross team member.  

Again, we hope to maintain our long relationship with Methodist Le Bonheur Healthcare facilities. Our proposed rates are in line with what other providers in Memphis and across Tennessee accept, and they would deliver millions in savings to help offset future increases for our members.  

BlueCross is a taxpaying, not-for-profit company that’s motivated by a mission to serve. Regardless of the outcome of negotiations, this will remain our focus. That includes making health care more affordable for Tennessee businesses and families — and ensuring they continue to have access to high-quality providers. 

Read the full article on Commercial Appeal’s website here.