Oregon’s Health Care at Risk: Providence-Regence Deadlock

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TL/DR –

In Oregon, contract renewal negotiations between Providence Health and Services and insurance company Regence Blue Cross Blue Shield may impact over 260,000 individuals’ health care. Providence Health seeks increased reimbursement rates from Regence due to rising health care costs and employee wages, including a 19% rise in drug and supply prices from 2020 to 2022 and significant losses since the COVID-19 pandemic; Regence views the requested increase as excessive. If an agreement is not reached by January 15, Providence will leave the Regence network, leading Regence-insured patients to face out-of-network charges at Providence facilities.


Oregon Regence Insurance Holders at Risk of Losing Coverage at Providence Facilities

Oregonians insured by Regence could lose coverage at Providence facilities if reimbursement rate negotiations are not settled by January 15.

Contract renewal discussions between a prominent Portland hospital group, Providence Health and Services, and leading Oregon insurance provider, Regence Blue Cross Blue Shield, are at an impasse, potentially impacting over 260,000 Oregon residents’ health care.

Providence is pushing for higher reimbursement rates from Regence to cope with escalating health care costs, citing a 19% hike in drug and supply prices between 2020 and 2022, wage increases, and significant losses since the start of the COVID-19 pandemic.

Regence, in a recent press statement, revealed Providence’s demand for a double-digit price hike that would require an excess of $144 million in a single year. The company warned this would lead to raised premiums and individual expenses.

If an agreement is not made before the January 15 deadline, Providence will exit the Regence network, forcing Regence policyholders to bear out-of-network charges at Providence facilities. The insurance provider’s Medicare Advantage network could also lose Providence by February 15 without a deal.

Local residents like Mary Grebisz, whose family relies on Providence’s specialized care programs, are deeply concerned by the situation. She worries that without an agreement, her family would face increased out-of-pocket costs or even have to travel beyond the city for comparable services.

Providence remains hopeful for a resolution within the next four weeks, encouraging Regence-insured patients with concerns to contact their insurance provider. The healthcare provider stresses that, despite efforts to control rising costs, they need the insurance companies’ support to adequately remunerate their dedicated staff.

Providence’s financial strains were further increased when nurses went on strike last summer, leading to historic wage hikes.

The dispute is specifically with Regence BlueCross BlueShield of Oregon, part of a separate association of nationwide health insurance companies under the BlueCross BlueShield umbrella.


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