Regence reaches deal on new contract with The Everett Clinic

EVERETT — Thousands of people who receive health care coverage through Regence got good news Friday: They can continue receiving in-network care at The Everett Clinic and The Polyclinic.

Those patients had been living with uncertainty for weeks as Regence BlueShield and Optum, the parent company of the two clinics, negotiated a new contract to replace one expiring this week. Regence announced the agreement late Thursday.

“We’re pleased to share that we have reached agreement with Optum to keep The Everett Clinic and The Polyclinic in network for our Commercial members. There should be no disruption in care for our Commercial members because of these negotiations,” reads a statement on the Regence website.

Regence will send letters to affected members and notify employers and brokers.

The dispute affected everyone with a Regence plan, including state and other public employees and retirees with the Uniform Medical Plan. Absent a deal, The Everett Clinic and The Polyclinic would have been out-of-network, meaning patients would face much higher bills.

The Uniform Medical Plan contract alone affects about 5,500 members who receive care at The Everett Clinic, and 10,800 members who receive care at The Polyclinic, according to the state Health Care Authority.

It isn’t all good news.

The agreement announced Thursday does not cover Medicare Advantage plan members. The parties are still negotiating terms of a new Medicare Advantage contract to replace the one that ended Dec. 5.

In November, Regence sent letters to members saying Optum demanded a double-digit increase in negotiated rates. Optum officials have not spoken in detail about the impasses.

Regence members with Medicare Supplement Insurance, also known as Medigap, may receive services from any provider that accepts Medicare. Medigap members are not affected by Optum’s decision and ongoing negotiations, according to a Regence press release.

Regence BlueShield is a nonprofit, independent licensee of the Blue Cross and Blue Shield Association. Regence reported over $95.8 million in profits in 2021, largely from investment gains, according to financial statements reported to the state Office of the Insurance Commissioner. It ended 2021 with a $1.55 billion surplus. Regence actually reported an underwriting loss: It spent more in claims and operating the business than it took in with premiums.

The Everett Clinic is part of Optum, which in turn is part of UnitedHealth Group, a massive health care company that earned $17.3 billion in profits in 2021. It has over $42 billion in cash and short-term investments as of Sept. 30.

Jerry Cornfield: 360-352-8623; jcornfield@heraldnet.com; Twitter: @dospueblos