MOUNTLAKE TERRACE — Providence Health &Services has announced that its contract with Premera Blue Cross will not be renewed, which could leave patients scrambling for doctors, hospitals, and perhaps even other insurance coverage beginning next year.
Providence announced its decision Wednesday. Premera-insured patients can continue to get services at Providence sites through the end of the year. But starting Jan. 1, Providence, and its affiliated organizations, Swedish, and PacMed, a group of clinics in King and Snohomish counties, will no longer accept Premera health insurance.
That would mean people insured through Premera either have to seek services outside Providence-affiliated health care organizations or pay “out of network charges,” which typically are far more expensive.
Medicare Advantage contracts through Premera will continue, said Colleen Wadden, a Providence spokeswoman.
Wadden said Providence wanted to let consumers know of its decision before open enrollment, when they can sign up for insurance for next year.
“It’s important for them to know what their choices might be for 2017,” she said.
An estimated 7,000 Providence patients in Snohomish County are insured through Premera. Statewide, some 500,000 Providence patients are insured through Premera, Wadden said.
Steve Kipp, vice president for Premera corporate communications, responded in a statement Wednesday, saying that Providence “abruptly terminated our contract” after months of negotiating.
“We ask Providence to come back to the negotiation table and let’s resolve this issue,” the statement said. “Let’s stop putting the customer in the middle and come to a reasonable solution.”
A Premera spokeswoman said Wednesday that the Mountlake Terrace-based organization would have no further comment.
Providence organizations in Snohomish County include two hospitals, Providence Regional Medical Center Everett, the county’s biggest hospital, and Swedish Edmonds, as well as a group of clinics, Providence Medical Group.
The decision also could affect Premera patients who get their medical care at clinics that are not part of Providence.
For example, The Everett Clinic sometimes refers Premera patients to Providence and Swedish for services. “We are still assessing how this will impact our patients,” Everett Clinic spokeswoman April Zepeda said.
In addition, the clinic’s own employee health insurance is through Premera, she said.
During negotiations last year, Providence and Premera reached essentially a one-year contract agreement with a commitment to work out a new agreement for 2017.
“Unfortunately, over the past year we’ve been unable to reach an agreement with Premera on the commercial contract for 2017,” Wadden said in a statement.
Barriers to reaching a new agreement include the payment rates to Providence and the development of a quality incentive program that meets state and federal goals for high-quality, accessible health care, according to the statement.
Sharon Salyer: 425-339-3486; salyer@heraldnet.com.
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