Tips for those stressed about losing MultiCare for in-network services through Regence
Area residents whose medical insurance is Regence BlueShield have discovered help is not so easy to find in some cases as Regence and MultiCare face off over their contract.
Following news of a proposed contract termination by March 1 between Regence and Tacoma-based MultiCare Health System, some of Regence’s insured individuals who are Medicare recipients reached out to The News Tribune.
Patients caught in the middle of the negotiations contended that little to any real assistance has been available to them when searching for new providers, as they were shuffled from Regence to state volunteers to Medicare representatives.
“I’m thinking there are a lot of people that are going to be ‘caught out’ by this deadline and won’t be able to respond soon enough to change providers,” wrote one self-described Regence client to The News Tribune.
Ashley Bach, strategic communications manager for Regence BlueShield, said via email in response to questions this week, “We remain hopeful an agreement will be reached with MultiCare before the MultiCare facilities go out of network on March 1.”
“This is catastrophic for me as a Regence MedAdvantage Plan member with many MultiCare specialists,” said a Tacoma resident, who did not want to be identified for fear of retaliation amid her personal insurance negotiations.
“I have long-term relationships with my MultiCare primary care and speciality providers and require in-network coverage. Even if I tried to locate another healthcare provider, outside (MultiCare) — which I do not want to — most all primary care practices are not taking new patients or if so the appointments are 6 months+ away.”
She added that the search for information and assistance took hours.
“I finally spoke with a person at Medicare.gov who had absolutely no idea of what I was calling about,” she said. “The lack of customer service, communication and understanding of the crisis is shocking.”
How we got here
MultiCare initiated termination of its contract with Regence midway through the contract’s term, Regence representatives told The News Tribune last month.
Regence, in a blog post on its site published Jan. 23, stated that MultiCare’s leaders issued a contract termination “to demand a double-digit increase in addition to the increase in rates they already agreed to.”
Regence estimates the termination, for now set to take effect March 1, would affect “hundreds of thousands” of people, according to the insurer.
Regence BlueShield, its health plan in Washington, serves more than 1.4 million people.
MultiCare, in a statement to The News Tribune last month in response to questions, said that “the rate of inflation as well as health care staffing costs have increased substantially over the past three years, and costs continue to rise due to labor shortages, drug prices and other factors.”
The health system added that it was “working with Regence to agree on reimbursement rates that reasonably and sustainably address the cost of providing care.”
What help is available
Stephanie Marquis is public affairs director for the Washington State Office of the Insurance Commissioner. In response to questions, Marquis told The News Tribune that “these are ongoing contract talks and both parties are continuing to work on getting to an agreement.”
For affected Medicare recipients, she touted the Statewide Health Insurance Benefits Advisors (SHIBA) program.
“Our SHIBA program can help people verify if a provider is with a certain plan,” she said via email. “They typically help them use the Medicare PlanFinder tool.”
However, “If this feels too urgent to someone, we are currently in the open enrollment period for Medicare Advantage so people could choose to switch to a different plan,” she wrote.
Marquis added that “hopefully they can wait a little longer to see if they parties work it out.”
Waiting too long, though, can come with its own risks.
“The (SHIBA) volunteer cautioned me to not delay in trying to find another insurance provider to be certain I receive my new uninterrupted coverage, insurance card and have the change lined up before the February 29 deadline,” the Regence MedAdvantage Plan member told The News Tribune.
Bach of Regence said, “We are fully committed to continue with negotiations and reach an agreement that retains our long-standing affiliation with these facilities, avoids disruption, and helps drive quality, affordable care for Washingtonians.”
Of note, he said, “Some Medicare Advantage members may be eligible to receive in-network treatment at MultiCare for a limited time after March 1. These may include members being treated for some chronic conditions, undergoing inpatient care, being scheduled for non-elective surgery or who are terminally ill. Please call us to see if you are eligible.”
Bach wrote that Regence’s “customer service team is ready to answer any questions members have. Our team can also help members find a new provider.“
Bach also noted that not all Medicare recipients are caught in the middle of the negotiations.
“Regence members with a Medicare Supplement Plan (known as Medigap) are not affected by the contract negotiation with MultiCare and may receive care from any provider that accepts Original Medicare, including after March 1,” Bach said.
Members are instructed to call the number on the back of their member ID card. Members can also sign in at regence.com to access their member account and search for in-network providers.
News Tribune archives contributed to this report.
