Bon Secours, Anthem lock horns

Published 8:02 pm Monday, June 23, 2014

Fees at Bon Secours Health Center at Harbour View for patients covered by Anthem Blue Cross Blue Shield are set to rise unless a dispute between the health system and insurer is resolved.

According to a letter from the chief executive officer of Bon Secours Hampton Roads, Michael Kerner, the health system and insurer have been attempting to negotiate a new contract for the past 11 months.

Recently, Bon Secours terminated its physician and facility contracts with Anthem, effective Nov. 7. Kerner called it a “difficult decision.”

Email newsletter signup

“It was not our choice to negotiate this way, but Anthem refused to participate in constructive conversations toward a new agreement,” Kerner wrote.

While negotiations between the two parties have been focused on Bon Secours-employed physicians and facilities, Kerner wrote, all area physicians would potentially be affected.

Eight Bon Secours facilities in Hampton Roads would leave the Anthem network, including Bon Secours Health Center at Harbour View and Bon Secours Surgery Center at Harbour View.

According to Kerner, during discussions on the new contract, Anthem assigned Bon Secours facilities to be in the first tier of its Hampton Roads health insurance exchange network only after the health system granted them a rate concession.

“The bigger issue, however, is despite our strong, long-standing relationship with Anthem, their most recent proposal would have produced a dramatic reduction in our total reimbursement over the next three years,” Kerner wrote.

“Their offer threatens the financial future of our Hampton Roads hospitals and significantly impedes upon the core of our mission to bring compassionate care and good help to those in need.”

The state’s sole faith-based health care provider does not have the financial resources to absorb the cuts, Kerner added.

But Bon Secours “remain(s) committed to working with Anthem in good faith to reach an agreement.”

The ongoing negotiations are not expected to conclude in the near future, Bon Secours Hampton Roads spokeswoman Lynne Zultanky said.

Anthem Blue Cross Blue Shield spokesman Scott Golden confirmed the dispute is over reimbursement rates, which “normally play a lead role in these types of negotiations.”

“Even though they made the decision to terminate the relationship, we are continuing to work (with Bon Secours) in good faith,” Golden said. “Our hope is that we can come to an agreement by Nov. 7.”

Such negotiations usually occur behind closed doors, he said, adding that Bon Secours’ decision to go public with the dispute “makes it a little more complicated to work through.”

“At the same time, we have a commitment to our members to give them access to the best health care possible, at a reasonable rate,” he said.