Michigan Medicine, Blue Cross Blue Shield reach tentative agreement; 12 hospitals would remain in-network for members
Blue Cross Blue Shield of Michigan and Michigan Medicine have reached a tentative contract agreement, ending a stalemate that threatened to disrupt healthcare coverage for thousands of Michigan residents.
Top executives from the insurance company and the healthcare system based at the University of Michigan announced the pending contract on Tuesday, just over a month before the June 30 end of the previous agreement.
Without the two having a contract in place, patients faced critical decisions on whether to pay much higher "out-of-network" medical costs or change their health care providers. BCBSM had estimated that about 300,000 insurance members and their employers would be affected after the dispute became public.
An "in-network" agreement means the insurance company and provider have agreed on what is considered to be payment in full for the provided services.
Under the proposal, Michigan Medicine's academic medical center and affiliated facilities, clinics and healthcare providers will continue to be considered "in network" in terms of the direct costs to patients. Michigan Medicine has 12 hospitals in the state.
Blue Cross claimed after the dispute went public that it was operating within what its customers are willing to pay, while the hospital system said its hospitals are underpaid for the care and treatment they provide.
The agencies said they will continue meeting to work out details ahead of a June 30 renewal date. Final terms of the contract will not be publicly disclosed.
But the agreement at this point will allow patient coverage to continue as "in-network" services.
"Blue Cross is pleased to reach this long-term agreement with our partners at Michigan Medicine – ensuring continued access to the system's medical care services for our members, while advancing the affordability of their care and coverage," said Tricia A. Keith, President & CEO of BCBSM.
"On behalf of our physicians, nurses and all of our team members, we are grateful to have reached an agreement that ensures continued access for our patients and for Blue Cross members across the state to the world-class care available at Michigan Medicine," said David Miller, M.D., Executive Vice President for Medical Affairs for the University of Michigan and Chief Executive Officer of Michigan Medicine.
