9/1/2023: Evergreen Health Contract Status with Regence
AGREEMENT REACHED! CHAOS AVOIDED
As you can imagine, we have been contacted by many concerned clients regarding this.
We expect this agreement will eventually be resolved. Insurance companies are constantly renewing contracts with provider groups. Negotiations are often complicated and drawn-out.
For obvious competitive reasons, there is great pressure on the insurance companies to keep rates as low as possible for their clients. At the same time, there is great pressure on the hospitals and provider organizations to cover their increasing costs. Last year, the hospitals in Washington state lost nearly a combined $1 billion dollars.
It’s not uncommon that negotiations get pushed into the public domain as each side attempts to gather client pressure for their benefit.
Last fall, Regence Blue Shield and Providence/Everett Clinic went public with their negotiations before they reached an agreement at the 11th hour. Last spring it was Cigna and UW Hospital/Physicians and earlier this year, Premera Blue Cross and Evergreen had a very public dispute that they settled three days prior to the April 1st deadline. Settlement is usually reached by the deadline, occasionally agreement is not reached until weeks after. Rarely do sides not come to an agreement as neither side can afford to lose the other.
Regence provides coverage to nearly two million people in WA, including Boeing and the WA State employees. To not come to an agreement at some point would be extraordinarily disruptive.
In our years of experience, we have rarely seen a complete contract negotiation failure. If there is not an agreement, know that urgent and emergency care will still be covered at EvergreenHealth Hospital in Kirkland. By law, Regence would also provide coverage for those scheduled to undergo nonelective surgery from the provider or facility, including receipt of postoperative care from such provider or facility with respect to such a surgery.
If there is a failure to reach an agreement, we could certainly review alternative options with you at that time.
Regence BlueShield most recent statement on negotiations
EvergreenHealth most recent statement on negotiations
Some of the reasons why the cost of care is increasing:
- Lack of Medical Professionals, especially nursing staff, is requiring healthcare providers like Evergreen to pay top dollar to maintain staffing levels to meet the demands of healthcare.
- Medicaid reimbursements have not kept up with rising costs. Medicaid reimburses significantly less than commercial insurers for claims incurred forcing healthcare providers like Evergreen to seek money elsewhere; hence the demand on the commercial markets.
- Federal Funding for COVID is expiring adding greater financial pressure on hospitals.