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UMMC to continue seeing all patients as negotiations over reimbursement continue with insurer

Published on Wednesday, July 17, 2013

By: UMMC Division of Public Affairs at 601-984-1100.

Published in Press Releases on July 17, 2013 (PDF)
JACKSON, Miss. – The University of Mississippi Medical Center has extended its contract with Blue Cross Blue Shield of Mississippi through August 28 as officials from both entities work toward a new agreement to provide fair reimbursement for medical services.

Regardless of whether the contract terminates, UMMC will continue to provide health-care services to all patients, including those insured by Blue Cross.
Should the contract terminate, Blue Cross insured patients will be out of network at UMMC and may face higher out-of-pocket costs and other cover age issues. UMMC, however, is committed to minimizing the impacts on patients, both financially and on coverage areas, for as long as it takes to negotiate a new contract.
"We apologize in advance for any inconvenience or hardship this may create for our Blue Cross insured patients. We want everyone to understand that we consider this a very serious matter or we would not have undertaken this course of action," said Dr. James Keeton, UMMC vice chancellor for health affairs.
The contract termination would not affect State and School Employees Health Insurance Plan participants and their covered dependents, as that plan is only administered by Blue Cross. Rather, it involves employee groups and individuals who are direct customers of Blue Cross in the commercial insurance market.

Citing reimbursement substantially below its peer institutions in neighboring states and midstream changes unilaterally made by Blue Cross that affect UMMC's reimbursement, UMMC administrators in February engaged Blue Cross in negotiations.
UMMC initially set a June 28 deadline to terminate the contract, extended it to July 17, and this week extended it through August 28. This will allow BlueCross time to notify its beneficiaries - UMMC's patients.
Keeton said UMMC is justified in asking for fair reimbursement from insurers that is consistent with its unique role as Mississippi's academic medical center. UMMC offers advanced care not available at other facilities, including the state's only Level 1 Trauma Center, only Children's Hospital, only level IV neonatal intensive care unit and its only organ transplant services, among many other exclusives.
Together with the Mississippi State Department of Health, UMMC leads the state's medical response during disasters. The availability of these services benefits all Mississippians.
As well, UMMC cares for the state's most complex medical cases, which often require multi-disciplinary teams of experts and sub-specialists.
Fully 75 percent of peer academic medical centers in the U.S. receive BlueCross reimbursement rates that average 29.6 percent higher than UMMC's.
As well, 75 percent of peer academic medical centers in the Southeast, receive Blue Cross reimbursement rates that average 11.7 percent higher than UMMC's.
"We want to assure everyone that we remain committed to working with Blue Cross to achieve a fair and equitable agreement. Most important, Blue Cross beneficiaries can continue to rely on UMMC for their care," Keeton said.
"Please know that whatever happens, we are here to take care of our patients and their families. We take our responsibility to the people of Mississippi very seriously and are making every effort to reach an agreement."
Patients seeking further information can visit http://www.ummchealth.com/insurance/.