Keeping Care Affordable
Where We Stand
Our first responsibility is to our members – making sure they have access to high-quality in-network care and keeping the cost of that care as affordable as possible. Our group customers’ and members’ need for affordability became more urgent during the pandemic and as inflation rose. To deliver the cost savings our customers need, we’ll be negotiating new contracts – or ending contracts – with some providers who are being paid or are requesting higher-than-average rates.
These decisions are always difficult and are never made without first considering how our members will be affected and how we can continue to serve their needs. Thankfully, this issue should have no impact on our members. Because of the provisions outlined in the Consolidated Appropriations Act (CAA), health care patients are now legally protected against balance, or surprise, bills from out-of-network providers. So even if a member gets care from an out-of-network provider practicing at an in-network facility, the member’s portion of the cost won’t change. The dispute concerns only how much BlueCross BlueShield of Tennessee pays the providers.
These providers are valued partners in caring for our members, and we want to continue our relationship. We have notified them that, if we are unable to reach agreement, the group will no longer be a part of our networks. It is our hope that, going forward, our in-network hospitals will encourage or even require their contracted physicians to join them in BlueCross networks, which are designed to fairly reimburse providers while keeping coverage affordable for our members.
Impacted providers include:
Envision Physician Services
Envision Physician Services provides care at facilities throughout Tennessee.
Medical Anesthesia Group
Medical Anesthesia Group serves facilities in Memphis and throughout West Tennessee.
Memphis Physicians Radiological Corp.
Memphis Physicians Radiological Corp. serves facilities in Memphis, Tennessee.