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Guest Blog Post: Dignity Health-Arizona
Guest Blog Post: Dignity Health-Arizona
At Dignity Health, our mission is to improve the health of the people we serve, especially those who are vulnerable. In service of our mission, we try to break down barriers to care wherever we can, and that includes cost barriers.
This doesn’t happen without strong partnerships with insurance companies. Contrary to popular belief, hospitals do not set their own prices for medical visits, procedures, and other services. We contract with insurance companies like Blue Cross Blue Shield of Arizona (BCBSAZ) to be “in-network” for you. These contracts determine the amount we are reimbursed for the care we provide, the way claims get processed, and how referrals and authorizations are handled.
Contracts usually span several years, so the amount we are reimbursed often is negotiated in advance even as our costs for supplies, medications, and labor all increase beyond expectations. We periodically ask insurance companies for reasonable rate increases so we can remain open and ready for any patient who needs us, 24/7, 365 days a year.
We have been in contract negotiations with BCBSAZ since September of last year. Unfortunately, BCBSAZ has not agreed to a new contract, which means our employed physicians and hospitals are now “out of network” for their members.
That means tens of thousands of BCBSAZ members who depend on our outpatient services like cancer care or imaging will lose in-network access to these care sites. And the BCBSAZ members admitted to our hospitals will be directed elsewhere, creating an unnecessary burden for families already faced with difficult circumstances.
We always negotiate with our mission in mind, and we know our communities are counting on us. We propose reasonable rate increases that allow us to compensate our caregivers fairly, maintain our facilities, and keep pace with inflation. All we ask is that BCBSAZ work with us in good faith, with patient care as the highest priority.
This negotiation isn’t the only place where we see BCBSAZ coming between patients and the care they need. Too frequently, our doctors are finding that BCBSAZ denies coverage for medically necessary treatment. This means the patient is left with a greater out-of-pocket responsibility, or they must wade through layers of “red tape” before they can get the care they need.
These delays can have serious consequences for the patient’s health. Even after a treatment is approved, BCBSAZ often refuses to pay our providers, requiring us to spend precious time and resources chasing down payment for care we’ve already delivered. This has become a serious problem. Currently, we have tens of millions of dollars in claims that BCBSAZ has refused to pay for 90 days or longer. This is part of what we’re trying to solve with our new contract, but so far, BCBSAZ has not been willing to cooperate.
Amid all these challenges, our top priority is still our patients, which is why we are committed to continuing negotiations with BCBSAZ in good faith to reach a new agreement. Our goal is to continue providing hospital and physician services to BCBSAZ members.
We’re asking BCBSAZ to come to the table with a genuine desire to partner and help us maintain access and choice for patients. When we work together toward shared goals, we can make a meaningful impact on the lives of those we serve. If you have insurance through BCBSAZ, please call the number on the back of your insurance card to let them know you want to keep Dignity Health in your network. For more information, visit KeepDignityHealth.org.
Tim Bricker
CommonSpirit Health
President, Central Region
Brian Tiffany, MD, PhD
Chief Medical Officer
CommonSpirit Health Central Region