Sen. Cooper urges health insurance compromise
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Of particular concern to Sen. Cooper is losing Blue Cross Blue Shield as a network provider for River Park Hospital since a large percentage of employers and individuals here have medical insurance with the company.
Losing Blue Cross as a network carrier would force patients to either travel to another hospital not affiliated with HCA, or find an alternative insurance carrier, a difficult proposition for many individuals, and even more of a problem for employers who would have to find and negotiate a competitively priced group insurance contract with another provider.
Sen. Cooper’s letters, dated Thursday, were addressed to Ms. Vicky Rutledge, CEO of Blue Cross Blue Shield of Tennessee, and Mr. Paul Rutledge, president of HCA.
Citing the seriousness of the situation, Sen. Cooper offered to appeal to the highest office in the state to provide an outside arbitrator acceptable to both companies.
“If you so choose,” he said in the letters, “I can ask Gov. Bredesen to give us a list of three arbitrator names. Because of the governor’s background in the health care industry, I believe he is in an excellent position to formulate this list.”
Cooper has been involved in trying to resolve the ongoing contractual dispute since the breakdown of negotiations late last year. The letters are the latest in a series of efforts to intervene in a positive manner in what is, for many local residents, a situation with potentially severe financial implications.
According to River Park CEO Steve Otto, the facility is one of only three rural hospitals in the TriStar Group, and the only medical facility of its size in Warren County, putting it in a unique situation.
Some compromises have already been made to try and lessen the impact on patients locally. Earlier in the year, River Park announced the facility would waive out-of-network charges until the end of February in hopes negotiations would resume and an agreement could be reached.
Otto says Sen. Cooper’s efforts are a step in the right direction, but made no prediction on what effect they would ultimately have.
“I think anything we can do to come up with a resolution that would be beneficial on both sides would be a good thing,” Otto said. “I think the people that are really getting hurt are the people in the community, and I would love to see something get worked out. But the effect these letters will have, I really couldn’t comment.”
Otto admits the two companies still have some pretty basic issues to resolve.
“You hear a lot of people say it’s about money,” he said. “I think HCA feels like they need a certain increase, and are asking for a reasonable increase, to cover costs that we have seen go up in recent years, and Blue Cross obviously feels like that’s too much. So, that’s where I think the main point of the argument is.”
Otto says he has not personally heard of any sort of negotiations going on, so it appears the companies are still at an impasse. Otto says although there are no easy solutions, he hopes there will be some alternatives.
“Hopefully, at the end of the day, if we don’t have a contract, then some other insurance carriers will come to town and be competitive,” he said.