Dr. Jordan Coffey and Dr. Hollis H. Halford III
Health care in our country is a complex system, but it is still the best in the world. We have the best access to care, the best treatments, and we are finding new and better ways to help provide care for our patients.
Unfortunately, there could be drastic changes to our healthcare landscape very soon, resulting in restricted access to care for patients in the Memphis and Mid-South communities. This is largely due to recent actions by Blue Cross Blue Shield of Tennessee (BCBST) to send out contract termination notices to several physician groups and healthcare facilities in the Mid-South.
The BCBST is demanding that a number of physician groups and health facilities accept drastic price reductions or exit the network. These rate reductions, in some cases, amount to a reduction of 40% or more for health care providers.
Our groups received this information through an impersonal form letter asking our practices to accept a whopping 40% rate reduction. BCBST did so without notice and without legitimate justification. They demanded that our doctors, our nurse anesthetists and our nurses accept these drastic cuts. Recruiting and retaining quality healthcare providers is already a major challenge for our practices and many others, and this unprecedented move by BCBST will only compound those challenges. More health care providers could leave Memphis if this tactic is allowed.
This action by BCBST will have a direct impact on our patients, families and communities throughout the Mid-South. This will affect our hospitals, emergency rooms and clinics. These facilities support some of the most underserved communities in our state. Care delivery in rural areas will be particularly affected, as tariff reductions of this magnitude mean that smaller care facilities may have to close. Insurance companies come out on top, while patients and healthcare providers bear the brunt.
From a financial perspective, BCBST posted net income of over $520 million in 2021, a 46% increase over the previous year, and they are looking for ways to further increase their profits. They are targeting physician groups and health facilities that have been part of the Memphis community for decades. They say it needs to be more competitive and in the best interest of patients, but it could ultimately lead to shrunken networks, restricted access to care for patients, and rotation of healthcare providers in the Memphis market.
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How and, more importantly, why does this happen? Insurance companies like BCBST are trying to take advantage of a new federal law called the “No Surprises Act”. The intent of the law is to protect patients, but, unfortunately, some insurance companies are taking advantage of this law to force healthcare providers and health facilities to accept drastic rate reductions or exit the network.
Our practices and service providers are committed to protecting patients against reimbursement disputes. Even though these harmful actions on the part of BCBST make it significantly more difficult for us to do our job and for patients to access quality care, we will never turn away a patient in need or sacrifice the level of care based on a patient’s ability to pay. .
We encourage you to join us in this effort. Let BCBST know that these cuts aren’t fair. Let your employer know that if your insurance is with Blue Cross Blue Shield of Tennessee, they put money before drugs and there are better options. We know that every voice can make a difference to help ward off this evil.
Jordan Coffey, MD, is president of the Medical Anesthesia Group. Hollis H. Halford III, MD, is president of Memphis Radiological PC
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