Medical services provided at two Central Minnesota clinics will remain in-network for Blue Cross and Blue Shield of Minnesota-insured patients after an agreement was reached between the insurance provider and a third-party insurance contract negotiator.
In an agreement reached Monday, Duluth-based Integrity Health Network has agreed to separate BCBS contracts for 20 affiliated clinics, including Sartell Pediatrics and Dr. Christopher Wenner’s practice in Cold Spring.
Blue Cross Blue Shield had terminated its multi-clinic arrangement with IHN in August. Without this agreement, those clinics would not have been in-network for BCBS-insured patients starting Feb. 1.
BCBS contract change affects northeastern Minnesota
“We had to concede our position,” said Jeffrey Tucker, IHN president. “Instead of negotiating one overarching contract for all of our clinics, we have to negotiate individual contracts (between Blue Cross and Blue Shield) and each of our clinics.”
IHN is an organization that, in part, negotiates insurance contracts on behalf of independent physician practices primarily across northern Minnesota and northwestern Wisconsin. IHN works with about 200 physicians in 47 independent clinics and facilities in 23 communities.
Through the IHN network, independent clinics are able to collectively bargain for more competitive costs for health insurance provider contracts. This allows IHN-affiliated clinics to devote more time to patient care and spend less time working with large insurance providers.
In a statement, Blue Cross Blue Shield Vice President of Provider Relations Eric Hoag said he is happy that agreements have been made to work with each individual IHN-affiliated clinic. Hoag stated this will allow BCBS to address clinic needs on an individual basis.
“I want to thank the leadership of Integrity Health Network for their assistance in coordinating the transition to this new model,” Hoag stated. “Ultimately, we all share the same goals of ensuring that patients receive the highest quality health care at the greatest value.”
IHN also works closely with other large health insurance providers in Minnesota, including HealthPartners, Medica, PreferredOne and UCare. Tucker said none of these providers had expressed any interest in pursuing an individual clinic relationship with IHN affiliates.
“The level of support we have received from other providers shows they see the value of our network,” he said.
Tucker and the staff at IHN will work closely with BCBS and each clinic to assist in forming contracts. BCBS has given IHN a 30-day window to finalize all 20 individual clinic contracts.
“Internally we have set a goal to restore relationships with (Blue Cross Blue Shield),” Tucker said. “It is not in anyone’s best interest to dwell on what happened. For us, it’s onward and upward.”
Date: January 31, 2017