Financial negotiations between two health care companies could have a big impact on many Yakima Valley residents.<\/p>\n
A dispute over the level of reimbursement has prompted MultiCare to send a notice of contract termination to Regence BlueCross BlueShield insurance. If the differences cannot be resolved, MultiCare facilities and providers in Yakima County will no longer be in-network for those covered by Regence insurance plans.<\/p>\n
Letters were sent last week to Regence plan members in Yakima, Grays Harbor and Thurston counties stating that if no contract is agreed upon by May 10, MultiCare facilities will be considered \u201cout of network\u201d care and members \u201cmay have to pay much more\u201d to access those providers.<\/p>\n
\u201cWe are a local, non-profit health plan. As such, our premiums and out-of-pocket costs for members directly reflect what providers charge for care,\u201d Regence said in a statement<\/a> posted on its website.<\/p>\n \u201cRegence invests 90 cents of every premium dollar directly into our members\u2019 health care. So, when providers demand more money, local businesses and consumers will pay more for their health care,\u201d the statement continued. “We are actively working to reach an agreement with MultiCare\u2019s leadership that strikes that balance.\u201d<\/p>\n A similar letter<\/a> was sent to Premera Blue Cross patients in May 2024 as the company was negotiating with MultiCare. The two companies reached an agreement<\/a> before their contract lapsed.<\/p>\n MultiCare providers affected<\/p>\n Based in Tacoma, MultiCare operates 13 hospitals and more than 300 primary, urgent, pediatric and specialty care locations across Washington, Oregon and Idaho. The not-for-profit health care system acquired Yakima Memorial Hospital in fall 2022.<\/p>\n The letter to Regence customers lists 23 Yakima County providers associated with MultiCare, including Yakima Memorial Hospital, several family medicine offices and numerous specialists. Among facilities listed are Children\u2019s Village, Orthopedics Northwest, Lakeview, North Star Lodge and Ohana Mammography Center.<\/p>\n MultiCare officials say they are hopeful an agreement with Regence can be reached by May 10, but if not, its facilities will be out of network for Regence plan members.<\/p>\n \u201cMultiCare remains committed to ensuring our patients have access to high-quality, affordable care close to home. That commitment is what guides our ongoing negotiations with Regence for a new agreement that would cover our entire health system,\u201d Scott Thompson, media relations manager for MultiCare, said in an email sent to the Yakima Herald-Republic.<\/p>\n \u201cWhile we have made progress and aligned on several important elements, we have not yet reached a final agreement,\u201d Thompson added. \u201cOur priority is to secure terms that allow us to continue caring for Regence members while also supporting the doctors, nurses, and teams who provide that care every day.\u201d<\/p>\n The MultiCare statement noted that while Regence is one of its largest commercial insurers, its reimbursement rates for hospital and clinician services are among the lowest.<\/p>\n \u201cThose rates have not kept pace with rising costs driven by inflation, workforce needs, and investments necessary to preserve services and ensure long-term stability for the communities we serve,\u201d Thompson stated in his email.<\/p>\n Options for Regence members<\/p>\n Regence, which serves more than 2.4 million members in Washington, Idaho, Oregon and Utah, informed Yakima County members in its recent letter that they can keep the in-network price for medical care up to 90 days after the MultiCare contract expires.\u00a0<\/p>\n Conditions for keeping in-network prices through Aug. 8 applies to plan members who are:<\/p>\n \u2022 Receiving services from a primary care provider<\/p>\n \u2022 Seeing the provider for a serious or complex condition, including certain chronic conditions<\/p>\n \u2022 Undergoing a course of institutional or inpatient care from the provider<\/p>\n \u2022 Being scheduled for nonelective surgery from the provider<\/p>\n \u2022 Being pregnant and seeing the provider for pregnancy-related care<\/p>\n \u2022 Being determined to be terminally ill<\/p>\n Under Washington state law, Regence plan members also may be able to see their primary care provider at the in-network price up to 60 days after receiving the company\u2019s letter about the contract ending.<\/p>\n Emergency room care, mental health and substance use crisis services will remain at in-network rates, Regence noted in its letter to plan members.<\/p>\n