Care at several South Puget Sound emergency rooms could cost more unless one of the state’s largest insurers settles its dispute with a group of doctors.
About a million 100,000 people in the state received a letter this month from Regence BlueShield. The letter warned of higher out-of-pocket costs beginning July 1 for people who visit ERs run by the Franciscan Health System and two others.
The amount of the increase is unclear. Adding to the confusion, even the effective date now is up in the air.
A Regence spokeswoman said Wednesday that there is no set date as negotiations continue.
The website for Franciscan, which is stuck in the middle of the dispute, said higher costs could begin Oct. 31. But Tuesday, a spokeswoman on behalf of the doctors group, Northwest Emergency Physicians, said higher costs could start Sept. 30.
“It just irritates me to dickens,” said Wayne Wolf, a postal worker in Federal Way who is covered by Regence. “I’m hoping people will come to their senses.”
Wolf, who in the past has made several ER visits as his wife was being treated for cancer, said people shouldn’t have to worry about higher bills during an emergency.
At the heart of the contract dispute is the doctors’ request for higher reimbursement rates for care. The increase was above what other comparable groups usually ask for, Regence spokeswoman Rachelle Cunningham said.
Regence and Northwest Emergency Physicians are continuing to work through the details in an open dialogue, said Tracy Young, spokeswoman for Team Health, a Tennessee-based company that owns NEP.
“We fully intend to work something out,” she said.
Regence sent a letter dated June 15 stating that emergency rooms staffed by NEP will have higher costs after July 1 when the contract between the parties was set to end.
The affected ERs are:
n St. Joseph Medical Center, Tacoma.
n St. Anthony Hospital, Gig Harbor.
n St. Clare Hospital, Lakewood.
n St. Francis Hospital, Federal Way.
n St. Elizabeth Hospital, Enumclaw.
n Cascade Valley Hospital, Arlington.
n Island Hospital, Anacortes.
Most of the ERs are part of the Franciscan Health System. Spokesman Gale Robinette said no patient will be denied care if the contract is terminated.
“The only reason our name is on the letter is because we contract with Northwest Emergency Physicians,” Robinette said. MultiCare Health System also outsources its ER care, but doesn’t use Northwest Emergency Physicians.
The outsourcing of emergency room doctors is “akin to a private practice,” Marce Edwards, spokeswoman for Multicare said. These specialized groups have expertise in emergency care, she said.
If the contract ultimately is not renewed, care at those certain ERs will become out-of-network, meaning they will cost a prescribed amount more depending on a person’s coverage plan.
Wolf, the Regence client, said people facing a true emergency might not have a choice about where they go. He worries about them getting a bigger bill in the mail after they’re treated. His wife, Faye Tompkins, is a cancer survivor. He remembers long waits in the emergency room at St. Francis when she had negative reactions to chemotherapy.
“I am so thankful for excellent care,” Wolf said.
Regence said for now nothing will change.
“At this point there is not termination on the table,” Cunningham said.
“It’s very unusual that a contract would come to this point.”
karen.miller@thenewstribune.com 253-597-8876 @karen_e_miller
