A hospital executive asserted in a full-page advertisement that patients are being used as pawns in a two-year-old dispute between emergency room physicians working in Everett and Monroe and two of the state’s biggest health insurance companies.
The advertisement, written as an open letter, was published last week in The Herald and two weekly newspapers. In it, Mark Judy, chief executive of Valley General Hospital in Monroe, calls for negotiations to end the dispute.
“When people come to the emergency room and expect a $75 co-pay and end up with a bill of $300 to $400, it’s a huge issue,” Judy said. “If you’re trying to make choices on clothes for your kids or gas for your car, $300 to $400 is a lot of money.”
Representatives of the physicians and the insurance companies said they, too, would like to see the issue resolved.
“In a general sense, we share Mr. Judy’s concerns and are committed to serving the needs of our members,” said Charlie Fleet, a spokesman for Regence BlueShield.
The maximum charge Regence is passing on to its customers for being treated by the emergency room doctors is $50, he said.
Premera Blue Cross spokesman Scott Forslund said Judy shares responsibility to consumers.
“Mark Judy does decide who staffs his emergency room,” Forslund said. “That said, we’re certainly not going out writing full-page ads blasting Valley General about this.”
Dr. Liam Yore, president of North Sound Emergency Physicians, said his organization agrees that “resolution is in everybody’s best interest.
“At this point, we don’t have any face-to-face meetings, but we will be talking between now and the end of the year to see if an agreement can be reached,” Yore said.
The emergency room physicians work under contract at Providence Everett Medical Center and Valley General Hospital.
Because the doctors have been unable to reach an agreement on payment rates with Premera and Regence, patients who have health insurance through these companies end up paying more out-of-pocket costs, sometimes several hundred dollars.
About 12,000 of the nearly 97,000 emergency room patients treated at the Everett hospital each year are insured through either Premera or Regence.
At Monroe’s Valley General Hospital, about 3,600 of the 20,000 people who go to its emergency room each year are insured through the two health plans.
“The public has little sympathy for your current position that transfers your financial responsibility to them,” Judy said in the ads.
“Our patients are people. Our patients are your patients, also. Please stop treating them as pawns, caught in the midst of your elongated business dispute over money,” he wrote.
The Monroe hospital’s board asked Judy to try to get the issue resolved. “The strategy was my idea,” Judy said. “I’ll take sole responsibility for it.”
The newspaper ads in The Herald and weekly newspapers in Snohomish and Monroe cost a total of $6,793. The hospital picked up the tab, Judy said.
The action was taken in part because major area employers, including Canyon Creek Cabinet Company, and employees at the Snohomish and Monroe school districts “have expressed significant concerns to us,” he said.
Patricia Neel, a second-grade teacher for the Snohomish School District, is one of the employees who has talked to Judy about the issue.
Neel said she got a letter from her insurance company announcing the change in how much it would pay for the services provided by emergency room doctors at the two hospitals.
A co-worker who went to the emergency room to be treated for a bug bite ended up paying several hundred dollars out-of-pocket, she said.
“I’m a little angry with continuing to pay more and having fewer services,” she said.
The emergency room physicians “indicated some time ago they wouldn’t contract with us unless we agreed to a significant reimbursement increase” of approximately 30 percent, Regence spokesman Fleet said. “We felt it would result in higher costs for our members and we didn’t think the rate was acceptable.
“We would certainly like to come to some agreement,” Fleet said. “Unfortunately, we’ve reached an impasse and have been unable to resolve it.”
Forslund, the Premera spokesman, said his organization would prefer to have no group of emergency room physicians outside its network.
North Sound Emergency Physicians, who work at the Everett and Monroe emergency rooms, is one of only four groups of emergency room doctors in the state with which it’s been unable to reach an agreement, he said.
When physicians decided not to accept the payment rates offered by the two insurance companies in 2004, his organization was in financial crisis, said Yore, the physician group’s president. Combined losses during 18 months in 2003 and 2004 hit $2 million, he said, so they had to take action.
Before taking out the ad, Judy said he tried to work with the physicians and the insurance companies. Earlier in the dispute, he said, he asked state Insurance Commissioner Mike Kreidler to help resolve it, but was turned down.
Stephanie Marquis, a spokeswoman for the insurance commissioner’s office, said that the agency can’t get involved in direct negotiations.
“We are actively involved in trying to encourage them to get back to the negotiating table,” she said.
Judy acknowledged that he may be criticized for saying that patients are being used as pawns in the dispute.
“These insurance companies and the emergency room physicians have it within their means to settle this,” Judy said. “Twenty-six months of letting this go unresolved is way too long. They’ve left the patients in the middle.”
Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.
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