Blue Cross Blue Shield Rejects Mission's Latest Offer, But Says It's Willing To Negotiate

Aug 10, 2017

Mission Health announced Thursday it wants to continue accepting Blue Cross Blue Shield insurance, but only for those who receive it through the healthcare exchange set up through the Affordable Care Act.  But the insurer rejected Mission's offer, saying it's unfair to those who have Blue Cross Blue Shield through other means, such as their jobs.  Both sides have been locked in a standoff after Mission earlier this summer announced it would no longer accept Blue Cross Blue Shield insurance because of a dispute over reimbursement rates.  The current contract between the two expires October 5th.  If no new agreement is reached, Blue Cross Blue Shield customers would find themselves 'out of network' at Mission facilities, meaning they would have to pay more for non-emergency care.  

Blue Cross Blue Shield is the lone provider offering insurance plans through the exchange in Western North Carolina.  Mission's offer would have ensured that tens of thousands of WNC residents would not have to pay more out-of-pocket expenses for non-emergency care at Mission facilities.  The company is by far the largest insurer in North Carolina, with over 70% of state residents that receive health insurance getting it from Blue Cross Blue Shield.  

In a statement, Mission president & CEO Dr. Ronald Paulus said, "We understand that those purchasing insurance on the exchange are among the most vulnerable in our region and have no alternative, so it is our responsibility to ensure that access to health insurance – a life transforming event – remains available to everyone.  By accepting BCBSNC’s “forever zero” approach for these individuals, we can help protect those who have exchange-based insurance, some being insured for the first ever time in their lives.”  

In response, Blue Cross Blue Shield President and CEP Brad Wilson said, "With today’s proposal, Mission Health continues to turn its back on senior citizens, state and county employees, businesses and taxpayers across Western North Carolina. This is unfair to tens of thousands of other members; therefore Blue Cross NC has no choice but to reject this offer.  We remain ready and willing to negotiate on behalf of ALL of our Western North Carolina members as soon as Mission Health fully withdraws its termination. A recent study validates that North Carolina already has some of the most expensive health care in the nation, and every increase in hospital costs leads directly to even higher premiums."

When Mission went public with its intention to drop Blue Cross Blue Shield, the insurer responded by essentially saying the matter was finalized, making no mention of any continuing negotiations between the two sides.  Blue Cross Blue Shield's statement today did seem to imply it's willing to talk with Mission again.

Mission is the largest healthcare provider, as well as the largest employer, in Buncombe County.  It operates several hospitals throughout Western North Carolina.  Its largest is in Asheville.