TAMPA, Fla. — A back-and-forth between two big players in the Florida healthcare field has recently gone public — a pretty unconventional move as far as insurance contract negotiations go.
And if Florida Blue and BayCare don't settle their feud soon, thousands of people in the Tampa Bay area could be looking for new doctors starting next month.
Here's what you need to know (especially if you're a Florida Blue-ensured Baycare patient).
BayCare's letter
Last week, BayCare Health System sent a letter to around 215,000 patients insured through Florida Blue announcing that its agreement with the insurance company will expire on Sept. 30, 2022, if the insurance company doesn't agree to a new contract.
"This has the potential to be a real hardship for patients, forcing you to find new physicians and potentially travel for care to avoid higher costs," it read.
"BayCare strongly desires to continue caring for patients with Florida Blue insurance. It is our hope that Florida Blue will agree to a new, fair agreement that puts patient needs first."
The letter urged patients to call Florida Blue themselves or ask their employers to call and let the insurance company know they want to keep access to BayCare hospitals.
Florida Blue's response
Florida Blue responded on its website, saying it wants to put patients' needs first, too — just not on the terms that BayCare proposed.
The insurance company explained that BayCare approached Florida Blue about negotiating a new contract back in Feb. 2022. The issue, according to the statement, is that Baycare is asking for "an extremely large increase" in payment.
"Unfortunately, BayCare is asking for an extremely large increase in the amount they are paid to care for our members. The total increases demanded by BayCare Health System are an excess $80 million that Tampa Bay and Polk County members and employers would have to pay each year – in addition to their current premiums and out-of-pocket costs. We cannot possibly put this excessive burden on the people and businesses in Pinellas, Pasco, Hillsborough, and Polk counties," the response read.
It goes on to say that the company is offering BayCare a competitive contract with a "meaningful" pay increase.
"We are disappointed and surprised that they expect an exorbitant rate hike that would impact the entire community," Florida Blue continued.
What happens if they don't agree?
If Florida Blue and BayCare do not reach a new contract agreement, all BayCare hospitals, doctors and other services and facilities will be considered out-of-network for people insured by Florida Blue starting Oct. 1, 2022.
This means you could be forced to pay higher out-of-pocket costs for each visit or find a new doctor who accepts Florida Blue insurance.
There is something called "Continuity of Care" available for Florida Blue-insured patients who may be undergoing treatment for a serious or complex medical condition at BayCare. Eligible patients would receive coverage for their treatments for anywhere from 90 days to six months even if the contract expires.
The Florida Blue and BayCare contract was last negotiated three years ago, the Tampa Bay Times reports. We didn't hear about it then, so why are we hearing about it now?
Tampa health insurance consultant Patrick Thornton told the newspaper that the move to make the debate public is likely an attempt for the companies to pressure the other side.
“It’s two heavyweights just stepping into the ring, and who’s going to flinch first is what it boils down to,” he told the Times.