POLK COUNTY — The contract between Salem Health and Regence Blue Cross Blue Shield is set to expire next year, but the organizations are still negotiating a new contact.
“Our members can continue to receive in-network care at Salem Health and Salem Health West Valley through June 30, 2019, and Medicare members can access in-network care through Dec. 31, 2019,” said Jared Ishkanian, spokesman for Regence.
Regence sent a letter to its customers in the beginning of November, saying they have been working with Salem Health contract that serves its members and “helps control costs.”
The letter states that customers are receiving the letter because, “Salem Health and Salem Health West Valley Hospital have been unwilling to negotiate a fair contract.”
Regence claimed that Salem Health is “more expensive than other in-network, local facilities.”
Ishkanian said negotiations with providers are a normal course of business.
“We use industry standard sources for a true comparison of hospital benchmarking data,” he said. “Our data shows that Salem Health is more expensive than other Oregon hospitals of similar size and quality.”
Members in Polk County could see health care costs “rise by almost 30 percent from 2016 levels if Salem Health’s demands are met,” the letter states.
“Salem Health makes decisions based on what is in the best interest of the health and well-being of the patients and communities we serve,” said Michael Gay, Salem Health spokesman. “In order to continue advancing our mission, we plan ahead for the ways health care is changing, both nationally and here in Oregon.”
Salem Health began negotiating with Regence “in August 2017 and continue to do so,” Gay said.
Gay said Salem Health’s prices are fair.
“Outside pricing consultants annually benchmark our prices and they consistently find that we are not the highest in the state, nor are we the lowest,” Gay said.
Salem Health currently has more than 200 contracts with other carriers, Gay said.
“When we negotiate contracts, our philosophy is that one insurance company should not receive a competitive edge over another from Salem Health, but should join with Salem Health and other insurance companies in pursuing improvements in access, affordability and quality,” Gay said. “Regence has been frank and blunt about demanding rates from Salem Health that are lower than what Salem Health charges other insurance companies. Regence is not willing to bear its fair share of the costs.”
If Regence and Salem Health do not reach an agreement before the expiration dates, Regence said members can seek care at other in-network facilities, including Legacy Silverton Medical Center/Silverton Hospital, Santiam Memorial Hospital, Willamette Valley Medical Center or Samaritan Health Systems.
Lisa Emerson, manager of Oregon SHIBA (Senior Health Insurance Benefits Assistance), said anyone already enrolled in a Medicare Advantage plan can change plans between Jan. 1 and March 31. That would include anyone on a Regence Medicare Advantage plan, whether talks with Salem Health break down or not.