Stillwater Medical Center and BlueCross BlueProtect of Oklahoma have come to an impasse in negotiations over who ought to pay for inflating prices of medical care. Both entities have introduced Stillwater Medical amenities will not be a BCBSOK in-network supplier on May 1, 2023, except they will compromise.
BCBSOK says SMC hospitals in Stillwater, Blackwell and Perry will not be in Blue Traditional, Blue Choice or Blue Preferred networks. SMC may also go away Blue Cross Medicare Advantage HMO and Blue Cross Medicare Advantage PPO networks on Jan. 1, 2023.
On Oct. 4, SMC notified Humana Medicare Advantage members that the regional hospital will not be a most well-liked in-network supplier as of Jan. 1, 2023. BCBSOK instructed the News Press they may notify members if SMC turns into not in-network.
SMC and BCBSOK have created internet pages outlining their facet of why negotiations have come to a standstill.
On their web site, SMC claims their prices have elevated 26% since 2019 and that they are going to be unable to take care of a excessive stage of care in the event that they settle for reimbursement contracts from insurance coverage supplier networks that don’t hold tempo with inflation.
BCBSOK’s web site says that SMC desires to extend costs by a number of occasions the speed of inflation. BCBSOK maintains they’re making an attempt to guard native companies and staff from steep worth will increase.
According to SMC’s webpage, the collective fee funds for BCBSOK’s sufferers comprise 21% of Stillwater’s affected person base.
SMC has said a deadline of Dec. 31 to reach an settlement. While BCBSOK communications supervisor Tricia Ament shared there is no such thing as a deadline and that BCBSOK is open to returning to negotiations.
Both the City of Stillwater and Oklahoma State University use BCBSOK to supply well being and medical insurance coverage to their staff. According to City of Stillwater Communications Director Dawn Jones, the town doesn’t understand how their staff can be impacted right now.
The hospital’s Board of Trustees voted to desk a report by SMC Chief Financial Officer Alan Lovelace on negotiations with BCBSOK on the Dec. 20 Stillwater Medical Center Authority assembly.
In a monetary report by Lovelace, SMC will see a $7-8 million loss for 2022 and forecasts for 2023 present elevated bills. However, the hospital ought to see a $5,000,000 revenue at a 1.2% margin. Lovelace famous a revenue margin of 3-4% is good and permits the hospital to maintain up with upkeep and price will increase.
“We need to do all we can to manage expenses during this season,” Lovelace mentioned.
The Board of Trustees additionally permitted naming the hospital’s new neonatal intensive care unit the OnCue NICU after the gasoline station and comfort retailer firm made a $1,000,000 donation.
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