‘It’s a shame:’ More than 200,000 Oregonians with Regence health insurance will no longer be able to get it at Providence facilities if a deal isn’t reached soon

Oregonians with Regence insurance will no longer be covered by Providence if the companies do not reach an agreement on reimbursement rates by Jan. 15.

PORTLAND, Ore. Time is running out on contract renewal negotiations between a major Portland hospital group and a major Oregon insurer, leaving the health care fate of more than 260,000 Oregonians hanging in the balance.

Providence Health and Services is seeking increased reimbursements from insurer Regence Blue Cross Blue Shield to keep up with rising health care costs and worker wages. Providence said drug and supply prices rose 19 percent from 2020 to 2022 and are continuing to rise, and the company also cited “large financial losses since the onset of the COVID-19 pandemic.”

In a news release two weeks ago, Regence said Providence had sought a “huge double-digit price increase” that would have cost more than $144 million in just one year, and claimed the result would be higher premiums and out-of-pocket payments. ; for example, raising the cost of having a baby by C-section by about $5,500.

Providence will leave the Regence network if the two companies don’t reach an agreement by Jan. 15 on the current contract, meaning patients with Regence insurance will have to start paying out-of-network prices at Providence hospitals. Providence would also exit the Regence Medicare Advantage network on Feb. 15 unless an agreement is reached.

“I’m concerned for all the people in this area, a lot of people depend on Providence for their health care,” said Kendall Stowell, who works near Providence Portland Medical Center.

Those people include Mary Grebisz and her children, who rely on the Providence system for specialized care. Grebisz said her children have emotional and intellectual disabilities, but Providence offers a program that has been a “saving grace” for the family. He said his family would be severely affected if the companies could not reach an agreement.

“It would probably mean that we would have to travel out of town to get these kinds of programs, or it could also mean that we would have to pay more out of pocket than we do now,” he said.

In a statement, Providence said it hoped an agreement could be reached within the next four weeks without disrupting patient care. Providence urged patients covered by Regence to contact their insurance company if they have any questions.

“We work tirelessly to counter rising costs, but we can’t do everything because we can’t accommodate those costs, which affects our ability to adequately pay the dedicated people who work in our clinics and hospitals,” Providence said.

This summer, Providence nurses went on strike and eventually won a historic pay raise, which the hospital says also added to its financial pressures.

Regence said in a statement that it is “fully committed to continuing negotiations and reaching an agreement that preserves our long-standing relationship with Providence Health.”

“Regence regularly works with providers across our state on network agreements that help manage the cost of care for our members,” the company said. “Our fees are based on what we expect the treatment to cost. If providers demand more money, our members and customers will pay more. These negotiations are not about Regence, they are about our customers. We act as their advocate in these discussions.”

“The way health care is organized today and the way it’s been in recent years, it doesn’t surprise me at all when it comes to medical and health care,” Grebisz said.

Their goal should be to serve more people, as many people as possible,” Stowell added.

BlueCross BlueShield is a brand that is distributed nationwide by an association of separate health insurance companies; the dispute with Providence involves Regence BlueCross BlueShield of Oregon.

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