Regence BlueShield of Idaho executives will travel to LifePoint Health in Tennessee the first week of February to work on a new agreement for St. Joseph Regional Medical Center in Lewiston.
LifePoint, the hospital’s owner, recently extended an invitation to Regence to visit after negotiations between the two parties stalled in the days before Regence’s contract with St. Joe’s expired last week, said Regence President Sean Robbins.
Earlier in the process, Robbins said, Regence offered to go to Tennessee, but LifePoint declined the meeting.
At the same time, LifePoint insisted on what amounted to a 40 percent increase over a three-year period in what it charges Regence for the care its more than 15,000 customers in the region receive at St. Joe’s, Robbins said.
“It’s what LifePoint requested, and it’s what LifePoint has stuck to, and it is why we drew the line and said, ‘Based on what?’ ” he said. “We’ve made five offers to them over the course of the last few months, and all of them were in good faith and earnest attempts to really address what they told us their challenges were.”
Robbins declined to share what terms Regence would accept.
St. Joe’s has no updates on the issue, said Samantha “Sam” Skinner, a spokeswoman for the hospital, in a text.
Hosting Regence executives in Tennessee is one of several signs that LifePoint’s stance is changing, Robbins said, noting that late Wednesday night, Regence received a new offer from LifePoint.
Regence is evaluating that proposal and not sharing the details publicly, he said.
He is also optimistic because St. Joe’s has a new CEO, Tim Trottier, who replaced an interim CEO, Mike Poore.
“We’re starting to make real progress together,” he said. “I want to believe that’s a function of new local leadership and our genuine desire to create … a local relationship with Tim.”
Both entities stand to gain from a compromise, especially if they involve innovative reimbursement models, Robbins said.
“The world is moving away from fee for service and just paying for volume,” he said. “The world is moving towards paying based on value and outcomes. I really see opportunities for us to work together to drive high quality together. I see opportunity around ... reimbursement arrangements that (encourage) proper quality and proper care.”
While Regence pursues a new deal with St. Joe’s, the insurance provider is monitoring what happens with its customers and providing them information.
It is taking regular tallies of Regence patients who have been diagnosed with cancer, are pregnant, have been treated in the emergency room or are admitted to the hospital.
Those are among the people who could be hardest hit by the impasse between the two entities. St. Joe’s is the only hospital with certain types of emergency care in the Lewiston-Clarkston Valley. It is also the only hospital in Asotin and Nez Perce counties that delivers babies and provides chemotherapy.
Since midnight Jan. 15, when the contract ended, much of the care Regence customers receive at St. Joe’s is being billed at higher, out-of-network rates.
Emergency will continue to be charged as in-network, even if the two sides can’t reach an agreement, and there are month-long grace periods for cancer and maternity patients.
But even in those instances, the hospital can balance bill patients for the difference between the amount Regence allows for certain services and what it costs the hospital to provide that care. Patients are responsible for those charges, and St. Joe’s hasn’t indicated if it will balance bill.
While the impact for the patients is the most significant, the dispute has other ramifications, such as patients going to other hospitals outside the Lewiston-Clarkston Valley, Robbins said.
“Nobody likes the situation,” he said. “This is not good for the people that we serve or (that St. Joe’s) treats.”
Williams may be contacted at firstname.lastname@example.org or (208) 848-2261.