More than 200,000 patients may have their health coverage impacted as contract negotiations between a major hospital system in Michigan and an insurer near their deadline.
Michigan Medicine and Blue Cross Blue Shield of Michigan have until June 30 to reach a deal. If the standoff continues after that, patients may need to find other physicians and networks for their medical care.
"Who wants to go to the hospital and find out oh, it wasn't covered," Wendy Dwyer, a Livonia resident who receives treatment for her chronic heart condition at Michigan Medicine, told WXYZ Detroit.
The contract dispute is over how much money Michigan Medicine is asking for to cover cost increases. Blue Cross Blue Shield of Michigan is concerned that higher payouts to the hospital system could mean less affordable coverage for its members.
"Our cost here at Michigan medicine has increased 30 percent or more — 45 percent if you look at our drug costs since the pre-pandemic times — and our payment rates have not increased significantly over that period of time so for us to continue to deliver a high caliber of care [and] support our teams, we need our contract to reflect that,” Scott Flanders, chief clinical strategy officer at Michigan Medicine, told FOX 2.
Andy Hetzel, vice president of communications at Blue Cross Blue Shield of Michigan, said the hospital system wants “too much money” in a statement to FOX 2.
Hetzel said the insurer respects Michigan Medicine’s “doctors, nurses and staff, but we need what we pay them to be affordable."
In a statement to The Independent, Hetzel said the insurer is working around the clock to try to reach a deal.
“We continue negotiating and have regular meetings on the calendar. Our teams are talking between meetings, and we are working hard to reach agreement on a new payment contract prior to Michigan Medicine terminating in-network access for our members on July 1,” Hetzel said.
The Independent also reached out to Michigan Medicine for comment.
If the dispute is not resolved soon, it will have real-life consequences for people such as Dwyer and another Michigan Medicine patient, Alaina Sullivan.
Sullivan, an Oxford resident with heart conditions, does not want to change providers.
"When I finally found this doctor who would treat the vasospasms, one of the first things she said to me when I finally found her was, 'Don't worry. I'm going to help you get your life back.' And she's still working on that," she told WXYZ Detroit.
More than 40,000 patients with Blue Cross Blue Shield insurance whose treatment of certain conditions at Michigan Medicine will still be covered 90 days after July 1, according to the local outlet.
Those conditions include pregnancy, cancer, transplant care, terminal illness and serious acute or chronic illnesses, according to Michigan Medicine.
“We are continuing to negotiate with Blue Cross to reach an agreement that would protect all patients’ in-network access to all Michigan Medicine providers, facilities and services in the longer term,” the hospital system said in a letter to patients reviewed by The Independent.
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