UMMC seeking new contract with Blue Cross & Blue Shield of MississippiPublished on Wednesday, May 2, 2018By: Marc Rolph at firstname.lastname@example.org or 601-815-5133The University of Mississippi Medical Center (UMMC) is in negotiations with Blue Cross & Blue Shield of Mississippi (BCBSMS) for an updated contract with the insurance provider, with the hope for a new agreement over the next two months.UMMC notified BCBSMS management Monday that it will terminate the current agreement on June 30, 2018.O'Mara“During the coming weeks, as we continue to negotiate with BCBSMS, absolutely nothing will change for our patients,” said Dr. Charles O’Mara, UMMC associate vice chancellor for clinical affairs. “We encourage Blue Cross members to continue to visit their UMMC care providers just as they always have. Our goal is to maintain business as usual, so our patients do not experience any disruption in their care.”Without a new agreement in place by June 30, UMMC will become out-of-network for BCBSMS customers, and those patients may face higher out-of-pocket costs. Normally, exceptions are made for patients who need emergency medical care or established patients who need continuation of care for an ongoing illness.Failure to reach an agreement also would not impact members of the State and School Employees’ Health Insurance Plan and their covered dependents, because that plan is administered by but not offered by BCBSMS.“We are committed to negotiating with Blue Cross in good faith,” O’Mara said. “However, it’s important to understand that our current agreement with Blue Cross was developed 28 years ago, when UMMC and the health care industry were vastly different. Most troubling, the base contract from 1990 allows Blue Cross to make any changes it wants to the terms of the agreement – including what it pays us for services we deliver to patients – without consulting UMMC.”As the state’s only academic medical center, UMMC offers the only Level I trauma center and children’s hospital in the state, the only organ transplant service, and one of the most extensive telehealth networks in the nation. Cook“Equitable contracts with our payor partners – like BCBSMS – allow us to keep the physicians, technology, facilities, staff and resources needed to provide the very best care possible to the people of Mississippi,” said Kevin Cook, CEO of the UMMC health system.Unfortunately, Cook said, BCBSMS’ ability to manipulate reimbursement even after an agreement is signed means that any rate proposal UMMC might agree to can’t be counted on unless the base contract is revised. “We are committed to a strong, collaborative and fair partnership with Blue Cross and Blue Shield that supports our mission to improve the lives of Mississippians through exceptional patient care, training the next generation of health care providers, and engaging in innovative research,” Cook said. “Through these continuing negotiations, we are optimistic we can reach a new agreement between our organizations.”Contrary to criticisms leveled by BCBSMS about UMMC’s costs and quality outcomes, data suggests that UMMC hospitals’ cost structure is among the lowest in the country, according to the Association of American Medical Colleges. Benchmarked against peer academic medical centers, the hospitals’ adjusted expense per patient day is well below the 25th percentile in recent national rankings.“We’re one of the best bargains in the country,” said Cook.Similarly, UMMC’s quality data have improved markedly over the last two years and continue on an upward trajectory in the most current ratings. Quality scores can lag by almost two years, so UMMC publishes its current quality data online.