After unsuccessful negotiations between Dignity Health Yavapai Regional Medical Center (YRMC) and Blue Cross Blue Shield Arizona (BCBSAZ), the latter’s insurance coverage no longer is being accepted at Greater Prescott’s largest hospital system, in some cases.
YRMC President and CEO Anthony Torres announced in February that the hospital’s locations in Prescott and Prescott Valley were not part of Blue Cross AZ’s coverage network and costs would be shifted to patients through out-of-pocket costs and deductibles.
Outpatient services provided by Yavapai Regional Medical Group facilities continue to be in-network, he added.
Torres said the two entities had not been able to reach an agreement after lengthy talks. “As a not-for-profit health care organization, we rely on reimbursement from health plans to sustain essential medical care and community benefits. Unfortunately, BCBSAZ has been unwilling to agree to a new contract that would put patients and our community first.”
He said the failure to reach an agreement could affect the medical center’s ability to provide “essential care” to the community and recruit doctors and nurses, while some patients may need to travel longer distances to receive certain types of care.
In mid-March, Dignity Health spokesperson Abby Kay told Prescott LIVING, “For nearly a month, Dignity Health Yavapai Regional Medical Center has been eager to have Blue Cross Blue Shield of Arizona return to the negotiating table and reach a fair agreement on behalf of its members.
“We are pleased that BCBSAZ has agreed to re-engage in negotiation discussions as both organizations have a responsibility to address this matter professionally, fairly and with a sense of urgency in the best interests of those who are directly impacted.
“It is our hope to work together toward an equitable contract that will put patients first and allow us to continue providing our full range of health care services. We apologize for the inconvenience this situation has created and sincerely appreciate the community’s patience as we continue to work through this negotiation,” she said.
In a February statement, BCBSAZ said the dispute affects about 20% of its 58,000 members in Yavapai County, and all will still have in-network care at YRMC for emergency treatment. The insurer contended YRMC was seeking reimbursement at twice the average rate for Phoenix hospitals.
Those currently out-of-network include members of PPO and EPO using the statewide/national Blue Cross PPO or EPO network, HMO plans using the statewide HMO network, Medicare supplement plans in the Senior Preferred Medicare Supplement Network, and plans using the BCBSAZ Workers Compensation Network.
Members of the Federal Employee Program and HMO Neighborhood Network plan members will be covered at least through the end of this year. Patients can find out whether they may be affected by the contract termination by checking their Member ID number at www.azbluefacts.com/yavapai.