Providence Health & Services officials said they won’t renew a commercial health-insurance contract with Premera for 2017, a move that could affect 500,000 people in Washington, including those who receive care through Swedish Medical Center.
Providence Health & Services officials announced Wednesday they will not renew a commercial health-insurance contract with Premera Blue Cross for 2017, potentially affecting more than 500,000 people in Washington.
The decision affects patients who receive Premera coverage for care at Providence, Swedish Medical Center and Kadlec Regional Medical Center sites in Washington, as well as affiliated doctors and clinics. Starting Jan. 1, those providers will be out of network for consumers who have Premera insurance. Until then, care will continue as usual.
A new contract remains possible, officials said, with talks continuing.
Providence officials said Wednesday the decision followed unsuccessful contract negotiations. Talks began in 2015, when the two parties reached a compromise agreement for 2016. But they were unable to come to terms on a 2017 contract, according to a statement by Colleen Wadden, a Providence spokeswoman.
Issues included rates, standard contracting terms across the system, and “the development of a quality incentive program that aligns our work with the goals established at the state and federal level for advancing high quality, accessible health care,” the Providence statement said.
Premera officials did not immediately respond to requests for comment.
Providence officials have posted a list of affected facilities and clinics at www.providence.org.
Providence officials said that more than 60,000 patients in their system have Premera coverage, but when factoring in providers that use Providence facilities, the impact could exceed 500,000 patients.
List of affected facilities and clinics from Providence.org:
Facilities and clinics terminating all Premera networks effective 1/1/17
• Providence Regional Medical Center Everett
• Providence St. Peter Hospital (Olympia)
• Providence Centralia Hospital
• Providence Sacred Heart Medical Center (Spokane)
• Sacred Heart Children’s Hospital (Spokane)
• Providence Holy Family Hospital (Spokane)
• Providence St. Joseph’s Medical Center (Chewelah)
• Providence Mount Carmel Hospital (Colville)
• Providence St. Mary Medical Center (Walla Walla)
• Kadlec Regional Medical Center
• Swedish Medical Center First Hill
• Swedish Medical Center Cherry Hill
• Swedish Medical Center Ballard
• Swedish Medical Center Edmonds
• Swedish Medical Center Issaquah
• Affiliated Medical Groups and Physician Offices including:
• Providence Medical Group
• Swedish Medical Group
• Pacific Medical Centers (PacMed)
• Kadlec-affiliated physicians