DETROIT – Beaumont Hospitals says its negotiations with insurance carrier Blue Care Network have hit an impasse, forcing the health system to make the decision that they will drop Blue Care in January.
Beaumont Hospital Chief Quality Officer Dr. Sam Flanders said the health system and Blue Care don't agree on pay. He said Blue Care is paying Beaumont 20 percent less than other hospitals for the same services.
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Blue Cross Blue Shield Spokesman Andy Hetzel said he could not say what the payment agreement is with Beaumont, but said Beaumont is asking for too much.
"Essentially, they are putting up a 'you are not welcome' sign on their hospitals for anyone who carries a Blue Care Network of Michigan HMO insurance card," Hetzel said.
Come Jan. 12, patients with Blue Care can still see Beaumont doctors and get emergency care, but hospital services -- such as scheduled surgeries -- would not be covered.
Flanders said the health system has already been covering costs.
"Over those three years, we've taken out over $300 million from our cost base," Flanders said.
Hetzel said Blue Care wants to reimburse through a new performance-based formula.
"How much profit can a non-profit hospital reasonably demand while keeping the cost of coverage affordable for people?" Hetzel said.
Beaumont has posted this statement on their website: A Message for our Blue Care Network Patients.
They have also taken out full-page ads in area newspapers.