HMA pleased with Blue Cross reinstatement of 4 hospitals but bemoans continued ‘squeeze’

blue-crossHealth Management Associates executives Tuesday welcomed Blue Cross & Blue Shield of Mississippi’s offer to reinstate in-network provider status to four HMA hospitals but say the contractual impasse still leaves some Mississippi communities facing a medical provider crisis.

Late Monday afternoon, Blue Cross & Blue Shield of Mississippi gave notice it is willing to reinstate network provider status starting Tuesday to Memorial Regional Medical Center in Amory; Northwest Regional Medical Center in Clarksdale, Tri-Lakes Medical Center in Batesville and Womens Hospital at River Oaks in Flowood.

In a press statement, the Naples, Fla.-based HMA termed Blue Cross Blue Shield of Mississippi ‘s partial concession offer an acknowledgment that “their decision to lock out 10 hospitals from their provider network was causing devastating consequences for patients, policyholders and communities.”

HMA said the other half dozen hospitals remain at risk over Blue Cross’ Sept. 1 severing of its provider contracts with HMA in response to an HMA lawsuit seeking an additional $19 million in reimbursements.

The hospital company has continued treating Blue Cross Blue Shield policyholders as in-network patients but says the costs make it unlikely the hospitals can continue doing that for long.

HMA, in its response Tuesday, said Blue Cross’ 81 percent share of Mississippi’s private health insurance market lets it continue “to squeeze the remaining hospitals” owned by HMA in the state.

“At the end of the day, however, one thing is certain: Insurance giants should not get to decide which patients and communities have access to quality healthcare,” said Dwayne Blaylock, CEO of HMA’s River Oaks Hospital in Jackson.

Blaylock termed the Blue Cross offer for the four hospitals “a step in the right direction” but hardly a fix for the hardships the impasse is causing.

“What about babies and mothers who need River Oaks’ cutting edge neonatal unit? What about Hinds County businesses reliant on a thriving Central Mississippi Medical Center? What about patients in Natchez and Biloxi  — don’t they matter too?”

In its announcement Monday, Blue Cross said it previously had made the offer on the four hospitals conditioned on HMA dropping its lawsuit. This time, Blue Cross is extending the offer out of its duty to show “leadership” in the dispute that could force closure of the Flowood, Amory, Clarksdale, Batesville and HMA hospitals elsewhere in Mississippi.

“Since HMA is not willing to take the necessary action for these hospitals that provide a unique service to their community, Blue Cross & Blue Shield of Mississippi will take the leadership role and move forward,” said Meredith Virden, manager of communications.

“As to the other HMA hospitals, significant issues regarding HMA’s charges and lack of focus on managing healthcare costs are still of great concern.”

Blue Cross said in a follow up to the press statement that the offer gives “these four hospitals the opportunity to reinstate as network hospitals effective Oct. 15 based on their prior Network agreement. There is no deadline or time frame to respond.”

The member-funded insurer emphasized that it felt the four hospitals are too valuable to their communities to be put at risk by the contractual dispute. “It is for this reason that we have moved forward with giving these hospitals the opportunity to be reinstated as Network hospitals,” Blue Cross said on an email reply.

HMA spokeswoman Kace Ragan said late Monday HMA is uncertain how long it can afford to continue treating Blue Cross policyholders as in-network patients. “It is definitely impacting our hospitals,” she said.

Confusion over the in-network status of patients has caused HMA hospitals to see drop offs in emergency room visits, surgical scheduling and other hospital services, according to Ragan.

The drop off is hurting HMA’s financial health and could bear on how long the hospital group can continue treating Blue Cross & Blue Shield policyholders as in-network patients, she said.

HMA’s six other Mississippi hospitals are:

>>>Biloxi Regional Medical Center;

>>>Central Mississippi Medical Center, Jackson;

>>>Madison River Oaks Medical Center;

>>>River Oaks Hospital, Flowood;

>>>Crossgate River Oaks, Brandon;

>>>Natchez Community Hospital

 

 

 

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