bcbs baptist health negotiations contract dispute resolved

After months of negotiations, BCBS and Baptist Health have finally reached a contract agreement. This dispute had been causing uncertainty for patients and providers alike.

The terms of the new contract have been agreed upon, but the specifics are not yet publicly disclosed. This lack of transparency has left many wondering what changes to expect.

The negotiations have been ongoing since the previous contract expired, causing some providers to stop participating in the BCBS network. This disruption had a ripple effect on patients seeking care.

The new contract is expected to bring stability to the relationship between BCBS and Baptist Health, allowing patients to continue receiving care from their preferred providers.

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Florida Blue and Baptist Health have reached an agreement, but the details of the agreement are not publicly disclosed.

The agreement was announced after several months of negotiations between the two parties.

Baptist Health is a large healthcare system in South Florida, and Florida Blue is a major health insurance provider in the state.

The agreement is expected to have a significant impact on the healthcare landscape in South Florida.

The terms of the agreement are not publicly available, but it's likely to involve changes to the way Baptist Health and Florida Blue work together.

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If you're a myBlue member, you might be affected by the recent changes in the Baptist Health network. As of Oct. 1, members with a myBlue plan no longer receive in-network cost share for Baptist Health services.

During the upcoming open enrollment period (Nov. 1 – Dec. 15, 2024), myBlue members can choose to switch to a different Florida Blue plan that includes Baptist Health in the network.

If you're a Medicare Advantage HMO or PPO member, you can continue to see Baptist Health specialists and access Baptist Health facilities at the in-network cost share. However, you will no longer receive in-network coverage for Baptist Health primary care providers.

Emergency care is always covered at the in-network cost share for all members, so if you're experiencing an emergency, go to the closest ER.

Florida Blue and NCH are currently in contract negotiations, and it's unclear if a resolution will be reached before the deadline. Florida Blue has asked NCH to agree to continuity of care for pregnant women who deliver at NCH through June 30, 2025.

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Here are some key dates to keep in mind:

If you're a myBlue member, it's essential to understand the changes affecting your coverage.

As of October 1st, myBlue members no longer receive in-network cost share for Baptist Health services.

Here's what this means in practical terms: if you have a myBlue plan, you'll no longer get the lower in-network cost for services from Baptist Health providers.

Fortunately, emergency care is always covered at the in-network cost share, so if you're experiencing an emergency, go to the closest ER.

If you're looking for alternative options, Florida Blue is working to help myBlue members transition to other quality in-network providers across Northeast Florida.

Alternatively, during the upcoming open enrollment period (Nov. 1 – Dec. 15, 2024), you can choose to switch to a different Florida Blue plan that includes Baptist Health in the network.

Here are the key changes to keep in mind:

Florida Blue is committed to supporting its myBlue members who are receiving critical healthcare services. myBlue members in active treatment for serious and complex cases with Baptist Health or Wolfson Children’s Hospital providers can continue to see their care team through Continuity of Care.

This program entitles eligible members to receive care at the in-network cost share for up to six months, or until March 29, 2025. Members should contact Florida Blue's customer service with any questions about Continuity of Care or for help getting the care they need.

Nemours Children’s Health is an independent physician practice and remains in-network for myBlue members. This means they can continue to receive care from Nemours Children’s Health without any disruptions.

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Collier County leaders are getting involved in the contract dispute between NCH and Florida Blue, with a deadline of September 30th looming. This will affect around 40,000 residents who are covered by Florida Blue plans and would become "out of network" if a new contract isn't signed.

NCH estimates that residents will pay more for services using NCH facilities that would be out-of-network. The nonprofit system has been urging residents to contact Florida Blue to resolve the issue.

People on Medicare Advantage plans with Florida Blue will be impacted, but those with Medicare supplemental plans won't be affected. This means that some residents will have to find alternative healthcare providers.

Contract disputes between hospitals and insurers are not uncommon, with Baptist Health in Jacksonville facing a similar negotiation deadline with Florida Blue. In fact, HCA Healthcare and UnitedHealthcare recently ended a stalemate just hours before their contract expired.

Florida Blue has offered NCH competitive terms, including an annual rate increase for inflation, which NCH has continued to reject. The insurer has also asked NCH to agree to continuity of care for pregnant women who deliver at NCH through June 30, 2025.

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Florida Blue says it has asked NCH to agree to continuity of care for pregnant women who deliver at NCH through June 30, 2025.

The insurer claims it has offered NCH competitive terms that include an annual rate increase for inflation, which NCH has continued to reject.

Florida Blue is concerned that there appears to be no clear path forward to close the deal before the upcoming deadline.

The reality is that Florida Blue's proposals are not aligned with NCH's, and discussions do continue.

Baptist Health is no longer participating in the myBlue network, a lower-cost HMO product, and Florida Blue is working to help myBlue members transition to other in-network providers.

Florida Blue plans that include Baptist Health in the network will be available to myBlue members during the upcoming open enrollment period, which is from November 1 to December 15, 2024.

About 40,000 residents in Collier County are covered by Florida Blue plans and would be impacted if NCH and Florida Blue can't reach a new contract by September 30.

NCH estimates that people on Medicare Advantage would be impacted by the contract dispute, but those with Medicare supplemental plans would not.

The contract dispute between NCH and Florida Blue has a rapidly approaching deadline, and Collier leaders are exploring their options to mitigate potential impacts on EMS patient transport services.

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