Florida Blue, BayCare on health care coverage

TAMPA — Tens of thousands of Tampa Bay residents will have to see new doctors in October as the region’s two major health care players officially battle over a new insurance contract.

BayCare Health System This week, it sent 215,000 letters to patients insured through Florida Blue, warning that BayCare hospitals, doctors and lab services will be out of the insurance network by Oct. 1 if the two cannot agree on new health care rates.

The contract, which includes services such as hospital care, appointments with primary care doctors and specialists, and diagnostic services such as X-rays and MRIs, was last negotiated three years ago. BayCare operates 15 hospitals in Hillsborough, Pinellas, Pasco and Polk counties in addition to an ambulatory department and BayCare Medical Group, one of the region’s largest physician groups.

In the letter, Baker Florida accuses Blue of “refusing to reach an agreement that allows patients like you to continue to receive services from physicians they know and trust.”

Florida Blue, the state’s BlueCross BlueShield provider, responded with a disclaimer on its website: “Unfortunately, BayCare is asking for a very large increase in the amount we pay to care for our members.” Such a large increase will significantly increase how much our customers pay for BeCare services and how much they pay each month for health insurance.

The dispute over prices comes as the pandemic and a national nursing shortage have pushed hospital costs up more than 20% since 2019, according to a report by the American Hospital Association.

Much of that increase is the result of more nurses leaving permanent jobs to become contract workers who can command higher weekly rates. In the year In 2019, contract nurses accounted for less than 5% of hospitals’ spending on nurses. Since January, that number has grown to nearly 40 percent, the report said.

At the same time, more than a third of health care spending — about $800 billion — went to insurance company costs and provider billing, 2017. A study in the Annals of Internal Medicine found.

The move to publicize the dispute is aimed at putting pressure on the other side, said Patrick Thornton, CEO of Tampa-based health insurance consultancy Anderson Thornton Consulting. Hospitals have benefited from the outbreak with federal subsidies to treat those with Covid-19, he said. Meanwhile, insurance companies collected premiums but reduced payments as hospitals delayed non-Covid-19 treatment.

“It’s two heavyweights in the ring, and it’s about who gets knocked out first.

Both Baker and Florida Blue blamed each other when asked about the dispute.

“Each year, Florida Blue requires its members and their employers to pay more for their health insurance coverage, but these increases are not shared fairly with health care providers like BayCare,” the company said in a statement.

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Florida Blue officials said BayCare is seeking a double-digit increase for hospital services and a nearly triple increase for diagnostic services such as X-rays and MRIs and other medical imaging. Dave Pizzo, president of Florida Blue Market of West Florida, said those increases will mean higher premiums for customers who are already struggling with higher costs for food, rent, gas and medicine.

“They are overpriced and overpriced in terms of the market,” he said.

By law, Florida Blue must give policyholders at least one month’s notice of a provider’s bankruptcy. About 85,000 letters were prepared at one print shop, officials said. Customers who have received service from BayCare in the past six months.

The BayCare letter was a surprise to Carrollwood resident Jordan German, 63. He and his wife are both covered by Florida’s Blue Plan, which is part of the Affordable Care Act.

The retired banker said he was shocked and saddened that such a contract would end mid-year when people were locked into insurance plans that could only be changed at the end of the year.

The Federal Marketplace allows people to switch insurance plans mid-year, such as for marriage, divorce and job loss or term insurance, but not because a provider ends coverage. according to healthcare.gov.

The German and his wife said they would either have to find new doctors or delay treatment until the end of the year and get new insurance. The couple isn’t dealing with health issues, but the German said the situation isn’t fair to those whose doctors and specialists are suddenly out of network.

“All we see these days are Baycare doctors,” he said. “I’m sure it will be very difficult to start coughing up more money in this economy.”