Out of Network

Good morning.

It’s April 1, but this update is no laughing matter.

Despite our best efforts to reach a resolution on a fair contract, UMMC is no longer in network with Blue Cross & Blue Shield of Mississippi, effective today. This is not the outcome we had wanted for our longtime partnership with the state’s largest insurer or for our patients who have commercial Blue Cross insurance, which is typically secured through an employer.

I am disappointed in Blue Cross’s failure, currently, to negotiate with us on a contract that reflects our role as the state’s only academic medical center and safety net hospital. Blue Cross insists that those factors, which clearly make us unique, don’t matter. They believe our one-of-a-kind specialists, critical care units, Level I trauma center, children’s hospital, transplant services and Level IV NICU make us like every hospital in the state. Despite the fact in many cases, the care or level of capabilities are found nowhere else in the state.

As I explained in the March 18 column, for months, we have been in discussions with Blue Cross about a new contract that gets our rates closer to – not equal to or above – what our peer academic medical institutions receive in neighboring states. That’s a critical point when we talk about rates but also about quality.

We want to be held to the same quality standards as other academic medical centers, not to the quality standards of community hospitals that don’t treat the same level of high-acuity patients that we treat.

But, instead of negotiating in good faith, Blue Cross seeks to mislead its members and the public about what’s really at the heart of their refusal to enter a new, fair contract: their profit margin.

The facts don’t change. By refusing to discuss a fair contract, Blue Cross has forced its members to pay more for their care at UMMC or select a provider outside of UMMC. The out-of-network status has far-reaching implications beyond Jackson, affecting our patients’ care statewide. UMMC-connected care is provided at more than 200 hospitals, clinics and telehealth sites across the state.

The Medical Center served approximately 50,000 Blue Cross commercial patients over the last 18 months. It remains my hope that we reach an agreement so we can continue to serve those who selected UMMC as their trusted health care provider.

Being out of network with Blue Cross doesn’t change our mission or what we do daily – care for Mississippians and others who seek our help. We want everyone to feel like they have an open path to care from any of our locations or providers statewide, but if this contract dispute continues long-term and Blue Cross members feel they can no longer seek UMMC care, we will still be providing lifesaving and life-changing care. We are in network with several other major insurance carriers, and demand for our services is high. Patients and community hospitals statewide recognize our value, and they rely on us. Each day, UMMC receives 30-40 patient transfers from other hospitals across the state. This is a clear sign that our partner hospitals know we are unique and provide services found nowhere else in the state, and we want Blue Cross to acknowledge it as well. It’s not debatable – UMMC is like no other hospital in Mississippi and we should not be treated as such.

Some of you may receive questions from commercial Blue Cross patients about this issue. I ask that you advise them to contact Blue Cross at the number on the health insurance card and they can let Blue Cross know the importance of their continued access to UMMC. They also can stay informed about the latest contract developments by visiting UMMCCares.com, and for other questions, patients may call us at 601-496-0008.

Emergency care will continue to be handled and billed as in-network. And according to federal continuity-of-care guidelines, UMMC patients who are in an active course of treatment or are in later stages of pregnancy will continue to be considered in network for a period of 90 days from today.

Lastly, I want to thank our health professionals and staff for working to accommodate Blue Cross patients during the rescheduling of appointments in March. I know it was challenging but our patients appreciated the efforts.

UMMC stands ready to return to the table for discussions about a new contract with Blue Cross. We want to continue the partnership on behalf of the patients we serve. It is in the best interests of all and a giant leap toward A Healthier Mississippi.