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State's Only Academic Hospital To End Contract with Blue Cross

Posted by Desare Frazier on
Kevin Cook, UMMC CEO at Podium, Dr. Charles O'Mara behind him
Desare Frazier

Mississippi's only academic hospital says it's pulling out of a contract with the state's largest private insurance company.

Officials at the University of Mississippi Medical Center say they will end their contract with Blue Cross Blue Shield of Mississippi, June 30. Kevin Cook is the medical center's CEO. At issue he says, is a 28-year old base contract he calls outdated. Cook says the contract allows the insurance company to change reimbursement rates without notifying the medical center. He says after a dispute with Blue Cross five years ago, they realized after negotiating rate increases the company reduced them over time.

"That's why we're focusing this time on this 28-year old piece of paper because in that 28-year old piece of paper it allows them to do that, and we find that unacceptable going down the road," said Cook.

Cook also contends insurance companies in other states with academic medical centers provide more financial support. He says UMMC serves a poor state, trains doctors and takes care of the sickest of the sick, yet Blue Cross doesn't recognize that burden. In a statement from the corporate office, Blue Cross Blue Shield of Mississippi says the payment program has continually evolved. It goes on to say UMMC wants to be treated differently from other network hospitals and has left reimbursement opportunities on the table. Blue Cross has also accused UMMC of not focusing on health outcomes and controlling cost.  Dr. Charles O'Mara who is with the medical center disagrees.

"We have made tremendous advancement in quality. It's reflected in publicly reported data from the medical center with steady improvement over the past three years," said O'Mara. 

Kevin Cook says he hopes they can renegotiate a contract with Blue Cross. The company says it will continue to provide network-level benefits to UMMC patients.

   

 

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