Providence to reserve some primary care appointments for commercial payers

Published 1:30 am Friday, September 26, 2025

EVERETT — Some Providence Swedish primary care clinics have started reserving a portion of appointments for patients on commercial insurance, a Providence spokesperson confirmed Wednesday.

About 5% to 10% of appointments will be unavailable to patients who are uninsured or covered by non-commercial insurance, including Medicare and Medicaid.

On July 1, 25 clinics began rolling out the scheduling changes, which affect all Providence medical groups across seven states. In addition to primary care, each medical group was encouraged to identify five specialty areas to be included in the rollout. Providence did not confirm which specialties were included in Washington.

The changes are intended to expand appointment access to patients, said Dr. Scott Foster-Edwards, regional chief executive for the north division of the Providence Clinical Network, in an interview Wednesday. About one-third of Providence’s patients are covered by commercial insurance, he said. Providence aims to implement the changes in all primary care clinics by the end of October.

“One of the biggest complaints that we get on an ongoing basis, some from health plans, but oftentimes directly from employers in the area, is that as they’ve been growing … and they’re hiring people and bringing people on, that their families can’t access basic health care and get their basic health care needs met, such as through primary care.”

If a reserved slot isn’t filled 48 hours before the appointment time, the slot will become available to all patients, Foster-Edwards said. Providers are also able to override the scheduling system when necessary, he said.

“As we’ve been renegotiating our contracts with payers, we talk to them about how much they will pay us, but at the same time, once we’ve got a contract, we’re obligated then to see their members, and this is us making sure that we have capacity to do that,” Foster-Edwards said.

In June, Providence announced a company-wide restructuring that eliminated 600 full-time equivalent positions, including more than 100 certified nursing assistants at Providence Regional Medical Center Everett. At the time, Providence cited financial strain from “an era of reduced reimbursement rates and higher costs.”

One provider at a local Providence clinic is concerned that the changes will make it more difficult for patients who are uninsured or are covered by non-commercial insurance to get appointments.

“It’s not going to benefit us unless it decreases access,” they said. “They attempt to foster their mission for the poor and vulnerable, I guess that’s why this really irks me because that’s why I chose Providence as opposed to somewhere else.”

Jenna Peterson: 425-339-3486; jenna.peterson@heraldnet.com; X: @jennarpetersonn.