Mission Health, a western North Carolina health system, is terminating its contract with Blue Cross and Blue Shield of North Carolina (BCBSNC), making it the only health system in the state not in the BCBSNC network.
Mission Health said BCBSNC’s latest contract proposal, which the payer is tying to quality and health outcomes, is not enough to keep up with rising healthcare costs.
Mission Health plans to leave the BCBSNC network Oct. 5.
Mission has said accepting BCBSNC's proposed contract could force the closure of many services and programs, while the payer maintains it needs to control costs, and points to other hospitals that have accepted the contract.
As part of the rather public and bitter dispute, Mission Health created a website, Stand With Mission, to give its side. The health system said BCBSNC has 72% of the market in North Carolina and has a history of getting what it wants.
“It has exercised its power by forcing healthcare providers into ‘forever’ contracts that renew automatically, with zero adjustments to the rates we are paid for providing healthcare services,” it said.
Meanwhile, BCBSNC said Mission Health “has historically enjoyed guaranteed rate increases from us, including every year of the current contract.”
BCBSNC said North Carolina already has some of the highest health costs, which are passed on to members through higher premiums. As a way to control these costs, the payer said it offered a new contract tied to quality and health outcomes, a two-year plan more than 40 other hospitals have agreed to. Contracts tied to quality and health outcomes are becoming more common for both private payers and CMS contracts.
Mission charged BCBSNC removed Mission's providers from its online directory, which Mission said created unnecessary confusion. The health system is telling its patients not to delay or change care plans until the contract ends in October. BCBSNC, though, said it has a regulatory obligation to notify Mission patients about the contract termination.
BCBSNC said it hopes Mission will retract its termination so that negotiations can continue, while Mission said it is looking to the payer to renegotiate the contract.
Patients caught in the middle are likely hoping that the two sides will ultimately reach a deal, similar to a situation in Minnesota last month. Blue Cross and Blue Shield of Minnesota and Children's Hospitals and Clinics of Minnesota had a similar heated contract dispute that resulted in the two sides not signing a new contract before a July 5 deadline. The two sides came to an agreement a few days later, but the terms were not disclosed.