The state’s largest health insurer is changing course in Wichita and will now let specialty hospitals and others join its network of preferred providers.
Previously, Blue Cross and Blue Shield of Kansas had an exclusive arrangement with Wesley Medical Center and excluded others from its network in Wichita.
Graham Bailey, vice president of communications for the non-profit insurer, said Blue Cross previously refused to let Wichita specialty hospitals into its network because it was trying to protect Wesley, which is part of Hospital Corporation of America, a chain with about 300 hospitals and surgery centers nationwide.
“We got a very discounted rate from (Wesley),” Bailey said, “and we just tried to protect them and not bring other hospitals into the system.”
A big concern, Bailey said, was that the specialty hospitals “siphoned off a lot of the cream” by focusing on “more profit-oriented procedures,” while foregoing costly emergency rooms and uninsured patients. That was believed to put Wesley at a disadvantage, hurting its revenue.
Bailey said he thought that the general hospitals in Wichita were now more comfortable with the specialty hospitals, in part because they now have some ownership stakes in some of them. Blue Cross policyholders also expressed interest in having other hospitals in their network, he said, so the company decided to open up its network to more hospitals in the city.
The specialty hospitals and others now will be allowed to negotiate with Blue Cross to join in 2010.
Blue Cross has already announced its Wichita network will include Via Christi, which hadn’t been in the Blue Cross system for the past 16 years, Bailey said.
And the specialty hospitals in Wichita had for several years made overtures about joining Blue Cross, he said.
“We will be offering them a contract, an opportunity to participate in our network in 2010,” Bailey said. “That doesn’t mean that they will be in the network. We’re not going to make an offer for more money than we think those services are worth. Obviously, they have to accept our allowances and not bill the patients for the balance.”
Bailey said Blue Cross has not yet renewed a contract with Wesley for 2010, but predicted that hospital also would be included in the network next year.
“Americans love choice and Wichitans love choice and they would much prefer to have access to all the hospitals instead of just one,” he said. “I think change is good for the landscape.”
-Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at mshields@khi.org or at 785-233-5443, ext. 123.