Regence Blue Cross Blue Shield members may eventually see Oregon Health & Science University and Hillsboro Medical Center move out-of-network, as the hospitals and insurer remain deadlocked in negotiations over a new contract.
Regence’s contract with OHSU and its Hillsboro affiliate expires on Dec. 31. Both sides say contract talks are active and ongoing, and in the worst-case scenario, patients will not feel any immediate impacts if the contract ends without a deal.
Regence members would still be able to receive in-network care at OHSU and Hillsboro Medical Center through the end of 2026, said Dean Johnson, a spokesperson for the insurance company.
Johnson said protections built into the existing contract prevent Regence members from facing higher bills if they seek care at the hospitals during the 12-month extension.
“Members would be able to use their health care coverage just as they do today,” he said in an email.
Sara Hottman, spokesperson for OHSU, said the health system would honor the full year of in-network access if the contract ends, giving patients time to finish treatment and plan ahead if needed.
She said OHSU’s talks with Regence come at a time when nearly all U.S. health systems are under financial strain from rising operational expenses.
“Securing fair agreements with insurers is critical so that OHSU and Hillsboro Medical Center can recruit and retain the best and brightest people, keep up with rising costs and reinvest in our mission to deliver the world-class care our community depends on,” Hottman said in an email.
Similar high-stakes standoffs between hospitals and insurers have become increasingly common across the country, often centered on reimbursement rates.
Providence nearly cut ties with Regence BlueCross BlueShield last year over reimbursement rates, but reached an agreement at the eleventh hour. OHSU had a similar dispute last year with UnitedHealthcare but reached a contract before it expired.
Hospitals say they need higher payments to keep up with rising labor and supply costs and to offset losses from Medicare and Medicaid patients, whose coverage often reimburses below the actual cost of care.
Hottman said OHSU’s recent agreements with UnitedHealthcare and Aetna reflect the value of the complex, specialized services it provides as Oregon’s only academic medical center.
Insurers, however, argue they need to manage reimbursement rates carefully to keep premiums from rising for employers and consumers.
In a recent update on its website, Regence said it is also trying to meet Oregon’s Cost Growth Target program, a statewide effort launched in 2019 to rein in health care spending. The program sets annual limits on how fast health care spending can grow, covering everything from hospital care to insurance premiums.