Showdowns in Broward and Palm Beach counties between hospitals and insurers like Florida Blue and Cigna over contract terms are pushing patients out of network for coverage and disrupting care as the new year arrives.<\/p>\n
Florida Blue and Broward County\u2019s two public health systems, both under the same CEO, still lack a new contract. The months-long impasse between Florida Blue and Broward Health<\/a> and Memorial Healthcare System<\/a> has affected as many as 40,000 policyholders who must deal with higher out-of-pocket costs, a disruption in their doctor relationships, and finding ongoing treatment for non-emergency care. Earlier communication from the parties indicated new contracts might be completed by year\u2019s end, but that hasn\u2019t happened.<\/p>\n \u201cWe are having ongoing and productive discussions with the leadership teams from Broward Health and Memorial Healthcare System,\u201d Florida Blue spokesperson Jorge Martinez said Tuesday.<\/p>\n In addition, unless Florida Blue reaches an agreement with Cleveland Clinic Weston by March<\/a>, notices will go out to policyholders informing them that the hospital will be out of network as well, meaning they will not be covered for non-emergency services. For now, Florida Blue members can continue scheduling appointments and receiving care as usual at the Weston hospital.<\/p>\n The inability to negotiate a contract, however, would put Florida Blue policyholders at a significant disadvantage when choosing care. Open enrollment for employer-sponsored health plans has now closed for most companies, forcing them to decide whether to continue with Florida Blue and Blue Cross Blue Shield. Martinez said it\u2019s too soon to know if and how contract disputes affected enrollment choices. Broward\u2019s public health systems have suffered, too, with patients delaying care or finding new providers.<\/p>\n In Palm Beach County, Cigna policyholders are about to lose in-network options, too.<\/p>\n Tenet\u2019s Palm Beach Health Network, which operates six major hospitals, is about to go out-of-network with Cigna on Wednesday. A Tenet spokesperson said that unless an agreement is reached by that Dec. 31 deadline, 1.3 million Florida Cigna policyholders and 13,000 Palm Beach County residents will not be covered for services at its hospitals. Those hospitals are Delray Medical Center,\u00a0 Good Samaritan Medical Center in West Palm Beach, Palm Beach Gardens Medical Center, St. Mary\u2019s Medical Center in West Palm Beach, and Palm Beach Children\u2019s Hospital in West Palm Beach. Tenet also operates Florida Coast Medical Center in Port St. Lucie.<\/p>\n Non-renewal of Cigna\u2019s contract will put the county\u2019s only children\u2019s hospital out of network, just as Joe DiMaggio Children\u2019s Hospital has gone out of network for Florida Blue policyholders in Broward County.<\/p>\n Cigna\u2019s standoff with Tenet\u2019s Palm Beach Health Network is part of a national contract dispute with Tenet Healthcare facilities and services nationwide. All of Tenet\u2019s hospitals, outpatient care centers, and health system-employed physicians will lose in-network status with Cigna plans.<\/p>\n Patients are increasingly caught in disputes as health insurers and providers disagree on contract terms and the two parties urge each other to stop disrupting medical treatment.<\/p>\n On Tuesday, a Cigna spokesperson said, \u201cUnfortunately, Tenet\u2019s hospitals in Palm Beach are seeking rates that far exceed the rate of inflation on health care services, which would make their hospitals and ambulatory surgery centers much more expensive for patients than other local facilities. We remain committed to negotiating in good faith to reach a fair and reasonable agreement that offers Palm Beach Health Network market-competitive rates and keeps them in our network.\u201d<\/p>\n Cigna noted that it has a robust network of in-network local providers to guide patients who previously have used services at Tenet hospitals.<\/p>\n The breakdown in negotiations between the two health care giants may represent the trend ahead, and the role AI will play.<\/p>\n