Salem Health is attempting to renegotiate medical group rates with Regence. Salem Health recently completed a two year deal with Regence BlueCross BlueShield of Oregon (Regence) that covers hospital services by both Salem Hospital and West Valley Hospital.
This agreement did not include the negotiation of new rates for professional services that are covered under a separate medical group agreement between Regence and Salem Health, which includes Salem Health Medical Group primary care providers, specialists and hospitalists. The rates payable under the Medical Group Agreement were last negotiated in 2010.
Salem Health sent a letter to Regence in late August which notified Regence that the medical group agreement would be terminated at year end and inviting the negotiation of new terms to be effective on January 1, 2018. Since that letter, Salem Health has made several and repeated efforts to negotiate new professional rates with Regence; however, Regence is refusing to negotiate new rates under the medical group agreement unless the termination letter is rescinded.
The medical group agreement has a special provision that extends the benefits of the contract for six months after its termination, so patients will not be impacted until after June 30, 2018, and only then if a new agreement has not been reached between Salem Health and Regence.
If an agreement is not reached by June 30, 2018, Salem Health Medical Group providers and hospitalists will become out-of-network for patients with Regence insurance. If an agreement is not reached by June 30, 2018, patients that have Regence insurance on July 1, 2018, will incur higher costs and disruption to coverage. This includes the Regence commercial Participating and Preferred plans, as well as the Regence Medicare Advantage plans.
Regence mailed letters to its Medicare Advantage members on November 16, 2017. In addition to the above information, the letter also encouraged patients to consider seeking other providers and listed The Salem Clinic, The Doctors Clinic, WVP Medical Group, Legacy Clinics in Silverton and Tualatin and Stayton Family Practice.
Regence has also stated its intention to mail letters to its other commercial subscribers; the timing for that mailing is uncertain.
Talking points for speaking with patients