PORTLAND, Ore. — Providence Health and Services and Regence BlueCross BlueShield are still struggling to reach a network renewal deal with just a few days left. If there's no breakthrough by Monday, Providence will leave the Regence network, meaning roughly 260,000 Oregonians with Regence insurance will be billed at out-of-network rates if they visit Providence hospitals.
The two companies have been deadlocked for weeks, with Providence seeking higher reimbursement rates that it says are necessary to keep up with rising labor and supply costs and Regence arguing that Providence's proposal is too expensive and would leave patients facing higher premiums and out-of-pocket charges.
Both companies said in statements Thursday that talks are still ongoing and they hope to reach a deal by Monday, but Providence added that it has begun contacting Regence patients with upcoming appointments to warn them about the potential change, and Regence said in its own statement that it is working to connect its members to other providers.
Providence's statement said the hospital group made a previous contract offer on Nov. 8 and received a counterproposal from Regence this week, but the counter "does not match up to the increases already agreed upon by other health insurers." Providence said it sent back a new proposal this week with what it described as significant concessions.
Regence's statement didn't mention the back-and-forth proposals but said that Providence "continues to ask for unrealistic price increases" and that Regence "must hold the line against this unprecedented, double-digit demand." Regence did not reply to a request for an interview.
Providence Oregon CFO Melissa Damm said the two companies have been working together to ensure that patients with specific ongoing care needs such as pregnancy or cancer treatment can continue to be billed in-network at Providence even if deal doesn't materialize. But only a small number of patients fall into that group, she said — most would need to find alternate providers.
"We have communicated out to those patients that have appointments with us, and we've made the decision right now that we won't be scheduling new appointments for Regence patients until we have come to an agreement, and hopefully that will be by Monday," she said.
It's technically possible to extend the deadline, but Damm said Providence already agreed to one extension to the current Jan. 15 date and doesn't want to pursue another due to the uncertainty created by the ongoing deadlock. She didn't directly answer when asked whether negotiations would continue if a deal didn't come together in time.
"Our focus right now and our hope is that we can come to an agreement by Monday, and that there won't be an interruption in the network and patients' ability to come and seek our services. So that's our goal and our sole focus right now," she said.
A Regence spokesperson told KGW that if an agreement is not reached in time, Regence will continue to have conversations with Providence in the hopes of bringing them back into the network in the future, but added that the company is still working to try to get a deal before the deadline.
BlueCross BlueShield is a brand name shared by an association of separate health insurance companies nationwide; the dispute with Providence is specific to Regence BlueCross BlueShield of Oregon.
