BlueCross, HCA end 14-month squabble
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The announcement was particularly good news for local residents since BlueCross is Warren County’s largest health insurance provider and River Park, a part of the TriStar Health System, is the county’s only hospital.
Both companies were pleased they had broken through the contractual impasse that had plagued both for more than a year.
“I’m real excited about it,” said River Park CEO Steve Otto yesterday. “I’m glad we’re once again a participating provider in the BlueCross network, effective April 1.”
“We’re happy,” added BlueCross spokesperson Bill Steverson. “We wanted a contract that was good for our customers and good for us as a company, and we think we got that. We think HCA got a contract that was good for them. It’s always good to work out something where both sides feel good about it.”
The agreement will run from April 1, 2004, through Sept. 30, 2006, and will include BlueCross Blue Networks P and C throughout the state, plus Blue Network S in Chattanooga and Jasper, according to company officials. Specific terms of the contract were not released by mutual agreement between the two health care giants.
Though it looked as if negotiations had fallen apart after state-sponsored mediation failed early in 2003, those close to the situation indicated both companies were still very much interested in forging an agreement.
Both Steverson and Otto said, despite what many people thought, the two companies had never really stopped talking since each had issues from previous contracts to discuss and both were involved with TennCare. Both men felt this continued communication probably helped lead to a resolution of the long-running dispute.
“First of all, we had had pre-existing contracts that we had to resolve,” Steverson said. “We also handle TennCare, and they participate in TennCare, and some Medicare programs. So we quite often talked, the various people in various departments talked to HCA’s people in various departments, and during those conversations, both sides threw out some ideas, threw out some thoughts, and over the months, things started jelling.”
Otto agreed, noting it had really been just a matter of time, since each was interested in developing a relationship that would be beneficial for both the companies and their customers.
“All along the two sides, I think, wanted to have a contract,” Otto said. “I think that was important, and most people may not realize that. I think the desire had always been there and I sense that the environment around those negotiations had improved dramatically over the last several months. As a result, we have an agreement.”
The news was doubly gratifying for River Park which, as a sole provider facility, had been waiving out-of-network penalties for BlueCross enrollees for the entire 14 months the companies had been without a contract.
“It was a bad situation for everyone,” Otto said. “Even though we were waiving out-of-network penalties, it certainly wasn’t an ideal situation.”
The sole provider status was a concern for BlueCross as well.
“We were especially concerned all along about the sole provider communities,” Steverson said. “McMinnville especially, and Jasper. So while we’re happy we have a contract with HCA for all of their hospitals now, we are especially happy that we have solved the problems of some of our members in those areas where the HCA hospital was the only hospital around.”