Fairview Health Services and Blue Cross and Blue Shield of Minnesota have reached agreement on a contract for next year, ending a dispute that threatened to block more than 250,000 patients from seeing their doctors at in-network rates.
Under the agreement announced Wednesday, Fairview clinics and hospitals will remain in Blue Cross’ provider networks. That means subscribers can visit Fairview health care providers without facing out-of-network rates that can be significantly more expensive.
The agreement ends uncertainty for patients about whether they’d need to switch doctors or pay more to visit the physicians they know.
“We are pleased an agreement has been reached, so patients with Blue Cross coverage can continue to access their Fairview providers and services at the in-network benefit levels of their plan,” said Dr. Beth Thomas, Fairview chief medical officer, in a statement.
The old contract between Fairview and Blue Cross was set to expire at midnight on New Year’s Eve. The new contract will stretch through the end of 2018.
While patients took to social media on Wednesday to express relief, the resolution didn’t come before the end of open enrollment earlier this month for Medicare beneficiaries. At the time, Blue Cross said about 45,000 people in the company’s Medicare health plans had visited a Fairview physician in the previous year.
“Blue Cross is glad our members can continue care with their Fairview caregivers,” said Garrett Black, senior vice president of health services at the insurance company, in a statement. “The agreement allows us to provide uninterrupted care and coverage to our members while addressing rising healthcare costs.”
Eagan-based Blue Cross is one of the state’s largest health insurers. Minneapolis-based Fairview is one of the state’s largest operators of hospitals and clinics, running the University of Minnesota Medical Center in Minneapolis and Fairview Southdale Hospital in Edina.
Neither side released terms of the new contract.
After the dispute went public in November, Fairview said it was negotiating for “the necessary reimbursement level to fund our mission and support exceptional patient care.” In a statement to the Star Tribune last month, Fairview said the health system has “a strong focus on delivering exceptional care and service while working to reduce the total cost of care.”
Blue Cross posted a statement on its website in late November that didn’t mention Fairview specifically but explained why the insurer makes network changes. “If we determine that a clinic or hospital is asking for a pay increase that is well beyond market standards,” Blue Cross said, “then we have an obligation to challenge those assumptions.”
In her statement Wednesday, Thomas said the agreement will “allow Fairview to continue providing exceptional patient care and service in the future while avoiding any disruption in care.”
Black said the contract maintains continuity of care “while addressing rising health care costs.”
Chris Haar of Minnetonka was among those impacted by the contract dispute who took to social media after Blue Cross and Fairview disclosed the contract issue. Haar’s 6-year-old son has been working with Fairview doctors on the process for receiving a cochlear implant, including appointments that stretch into next year.
Without a contract settlement, the family would have had to start the process all over with different doctors, Haar said. He has Blue Cross coverage through his employer, so he didn’t have a choice of a different health plan that includes Fairview.
“It’s a relief,” Haar said Wednesday of the agreement.
Health insurers and hospital groups periodically struggle to reach contract agreements. Usually the disputes are settled before patients are blocked from seeing doctors, although that’s not always the case.
A contract dispute between Minnetonka-based Medica and Minneapolis-based Children’s Hospitals and Clinics of Minnesota went public in November 2014 and was settled within a few weeks without a patient impact. Patients didn’t experience disruptions from a dispute between Blue Cross and Regions Hospital in St. Paul that settled in December 2013.
Last year, however, Medica and the mental health care provider PrairieCare could not reach an agreement on financial terms before a contract expired.