CHAPEL HILL, N.C. – After issuing an ultimatum for a 36 percent fee increase, N.C. Baptist Hospital in Winston–Salem has cancelled its contracts to serve as an in–network health care provider for members of Blue Cross and Blue Shield of North Carolina (BCBSNC).
BCBSNC offered the hospital a significant increase, but the hospital broke off discussions and cancelled its contracts when its demands for a 36 percent increase were not met. The rates BCBSNC currently pays N.C. Baptist Hospital are already about 10 percent more than the average for other academic medical centers in the state.
The hospital’s contract cancellations are effective on June 4. The cancellations apply to all BCBSNC network products. At this time, the State Health Plan is not affected because it has a separate contract with N.C. Baptist Hospital.
"Increasing the hospital’s fees by such a large percentage would put too great a burden on our members, who already pay higher hospital costs than members in other metropolitan areas of the state," said Milo Brunick, BCBSNC vice president of Network Management. "We offered the hospital a reasonable increase, but accepting this ultimatum would not have been in our members’ interest."
"We regret that N.C. Baptist Hospital is putting our members in the middle," Brunick said. "We were willing to continue to negotiate in good faith in hopes of reaching a mutually beneficial conclusion. Given the hospital’s decision to stop serving as an in–network provider for our members, our focus is now on making this a smooth transition."
BCBSNC has contracts with all other hospitals in the region, including Forsyth Medical Center in Winston–Salem, Moses Cone Memorial Hospital in Greensboro and High Point Regional Hospital in High Point. No physician practices are affected by the termination.
N.C. Baptist Hospital’s action means that in–network care for BCBSNC members at the hospital will be limited to emergency care and care that is not reasonably available at other region hospitals. Most BCBSNC products allow members to receive benefits for services provided at an out–of–network facility. However, members typically pay higher out–of–pocket costs for out–of–network care. BCBSNC members should work with their physician to assure that they have appropriate authorization before receiving care at any out–of–network facility.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.1 million members, including approximately 549,000 served on behalf of other Blue Plans. The company offers its members the Blue ExtrasSM value–added programs, which provide discounts and information on a wide variety of health–related services at no additional cost. BCBSNC also offers life, dental, long–term care and disability insurance products. For 71 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health.
BCBSNC’s HMO product has earned Excellent Accreditation from the National Committee for Quality Assurance (NCQA), an independent, not–for–profit organization dedicated to improving the quality of health care. BCBSNC also has North Carolina’s first and only NCQA accredited PPO plan – Blue OptionsSM. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at