OSF Hospitals To Exit Blue Cross Blue Shield Network | WGLT

OSF Hospitals To Exit Blue Cross Blue Shield Network

Oct 10, 2017

Illinoisans with Blue Cross and Blue Shield PPO health insurance will no longer be able to get in-network care at OSF HealthCare hospitals around the state, including OSF St. Joseph Medical Center in Bloomington.

OSF HealthCare announced Tuesday that it was terminating its agreements with Blue Cross and Blue Shield of Illinois (BCBSIL) due to a dispute over the changing size of the insurer’s PPO network. That dispute had already lead to Blue Cross and Blue Shield dropping three OSF hospitals from its network, and OSF is now pulling its other hospitals out as well. The change will go into effect Jan. 1.

“OSF HealthCare is an accountable care organization committed to population health, which is achieved through ensuring patients have access to the full resources of its integrated health care delivery system,” Randy Billings, OSF HealthCare senior vice president of population health, said in a statement Tuesday. “By eliminating three of our hospitals from its network, Blue Cross and Blue Shield eliminates important referral centers and patient access to nearby specialty care, including our children’s hospital.”

OSF HealthCare said it was "disappointed and concerned" about the decision by BCBSIL.

"We hope they realize the value of having OSF hospitals in-network for their members. OSF is open to future discussions with BCBSIL to avoid a disruption to patients,” OSF said in a statement.

All of OSF HealthCare is participating in the Blue Cross and Blue Shield PPO network through the end of 2017,” OSF added.

“Patients are encouraged to continue to use our services through the remainder of the year,” OSF said.

Individuals who wish to switch to new plans do have options, OSF said in its statement. If an employee is in an open enrollment period, and their employer offers multiple options, OSF hospitals are participating in most other national and local managed care plans, the organization said.

In a statement, Blue Cross and Blue Shield of Illinois said it was committed to "our members, our group customers, as well as the communities we serve."

"Our current PPO and BlueChoice contracts with (OSF's) St. Francis Medical Center in Peoria, St. Anthony Medical Center in Rockford and St. Mary Medical Center in Galesburg no longer serve BCBSIL’s aim to continue to broaden our members’ access to network providers and further enhance our network and product offerings," BCBSIL said in its statement. "Our mission is to continue to provide access to quality, cost-effective healthcare in Illinois. That includes creating and designing networks that balance access and affordability of care. We are open to continuing contract discussions with the goal of reaching an agreement that benefits our members and customers.”

A Country Financial spokesperson said that BCBSIL has notified the Bloomington-based company that its current OSF HealthCare contracts will end Jan. 1.

"BCBSIL officials have told us it’s their intention to renegotiate the OSF contracts, and they hope to do so before the actual termination date of the existing relationships," Country spokesperson Chris Stroisch said in an email. "However, it was necessary under the existing contracts that 90-day notice be given."

A State Farm spokesperson declined to comment Tuesday.

The contract termination does not affect OSF HealthCare Medical Group and other non-hospital providers.

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