Florida Blue will continue covering Health First services after the two companies reached an agreement Friday – the day their current contract was set to expire.
Health First notified customers Friday afternoon that it had entered a two-year contract with Florida Blue. If the companies hadn’t reached an agreement Friday, Florida Blue and Blue Cross Blue Shield plans would have stopped covering services at Health First hospitals and with affiliated physician groups starting Saturday.
The change would have affected BlueCare, BlueChoice and BlueOptions plans across the entire Blue Cross Blue Shield network because Florida Blue negotiates rates for plans across the country.
The contract under negotiation dictated the rates at which Florida Blue reimburses Health First for services. Details of the agreement were not made public.
Contract negotiations usually happen silently, but this time Florida Blue publicly warned customers that the insurance company and Health First were struggling to reach an agreement and hospitals might go out of network. Beginning Nov. 11, Florida Blue notified 4,667 members who have seen a Health First provider within the last six months as well as employer groups throughout Brevard County.
In internal communications obtained by FLORIDA TODAY, Florida Blue said Health First was asking for reimbursements high above market value for its services.
“Health First is insisting on a significant increase in reimbursement rates that would raise its payment structure well above similar hospital systems in the state,” read an internal memo. “If Florida Blue agreed to Health First’s contract demands, the cost of care would rise significantly for Brevard-area members who use Health First facilities.”
In an email to customers the same day FLORIDA TODAY published a report on the dispute, Health First called those claims a negotiation tactic and said its terms fit within reasonable market standards.
“While Florida Blue is trying to exert negotiating leverage over Health First through the media, do not be misguided by their narrative,” Health First wrote in the letter. “This is being done in an effort to completely negotiate in favor of their profit margin, not in the name of providing quality healthcare at a fair price.”
Florida Blue wouldn’t provide statistics on how many Brevard customers Blue Cross Blue Shield insures in Brevard County, but Blue Cross Blue Shield is the largest insurer in Florida.
Source: Florida Today