TAMPA — Tens of thousands of Tampa Bay residents may have to find a new doctor by October as two of the region’s leading healthcare companies openly battle over new insurance policies.
The BayCare Health System has sent 215,000 letters this week to patients who have insurance through Florida Blue, telling BayCare hospitals, doctors and laboratory services to notify insurers by October 1 if they cannot agree on new medical rates. warned that you will be excluded from the network of
The deal includes agreements on medical expenses, including hospital treatment, visits with family doctors and specialists, and diagnostic services such as X-rays and MRIs, and was last negotiated three years ago. . BayCare operates 15 hospitals in Hillsborough, Pinellas, Pasco and Polk counties, along with an outpatient department and BayCare Medical Group, one of the region’s largest groups of physicians.
In the letter, BayCare accused Florida Blue of “not wanting to reach agreements that ensure patients like you can maintain the services they rely on from doctors you know and trust.” .
Florida Blue, the state’s BlueCross BlueShield provider, responded by rebutting on its website. Such a large increase would significantly boost the amount a customer would pay for his BayCare services, as well as the amount he would pay for his monthly health insurance. ”
Controversy over costs has erupted as hospitals’ costs have increased by more than 20% since 2019 due to the pandemic and a nationwide nurse shortage, according to a report by the American Hospital Association.
Much of that increase is the result of more nurses leaving full-time jobs and becoming contract workers who can demand higher weekly wages. In 2019, contract nurses accounted for just under 5% of hospital nurse spending. As of January, that number had surged to almost 40 percent, the report said.
At the same time, more than a third of healthcare costs (about $800 billion) are spent on insurance company overheads and healthcare providers’ time spent on claims, published in the Annals of Internal Medicine. A 2017 survey revealed.
Patrick Thornton, CEO of Anderson Thornton Consulting, a health insurance consultant in Tampa, said the move to go public with the controversy was likely an attempt to put pressure on the other side. , he said, benefited from the pandemic through federal grants to treat COVID-19 patients. In the meantime, insurance companies collected premiums, but reduced payments as hospitals delayed non-COVID-19 treatment.
“It’s about two heavyweights who just stepped into the ring and who flinched first,” he said.
BayCare and Florida Blue have blamed each other when questioned about the controversy.
“Each year, Florida Blue asks members and employers to increase health insurance coverage, but that increase is not shared proportionately with providers like BayCare,” the company said in a statement. I’m here.
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BayCare aims to double-digit prices for hospital services and nearly triple prices for medical imaging services such as X-rays and MRIs, according to Florida Blue officials.These increases mean higher insurance premiums for customers at a time when families are already struggling with rising costs for food, rent, gas and medicines, said Dave Pizzo, president of Florida Blue Market in West Florida. rice field
“Considering the market, they are outrageous and excessive,” he said.
By law, Florida Blue must notify policyholders of provider loss at least one month in advance. About 85,000 letters have already been prepared at the printing house, officials said. For customers who have been serviced through BayCare within the past 6 months.
The BayCare letter came as a surprise to Jordan German, 63, of Carrollwood. He and his wife are insured through the Florida Blue plan provided as part of the Affordable Care Act.
A retired banker said he was shocked and disappointed that such policies would expire in the middle of the year when people were stuck with insurance plans that could only be changed at the end of the year.
In the federal market, major life events such as marriage, divorce, unemployment, and insurance plans for current insurance can be changed mid-year, but not because a single provider has stopped coverage. According to health.gov.
German and his wife will have to find a new doctor or delay medical care until the end of the year and find new insurance, he said. said it was unfair that doctors and other specialists were suddenly removed from the network.
“Everyone we see right now is a BayCare doctor in the network,” he said. “I’m sure it’s going to be really hard in this economy to start damming up additional funds.”