Confluence Health breaks contract with Premera, the state’s second-largest health insurer
WENATCHEE – North Central Washington’s largest health care provider said on Tuesday it will no longer accept insurance from the state’s second-largest health care provider.
Confluence Health will be terminate his contract with Premera Blue Cross on what he calls “Premera’s refusal to pay a rate consistent with that of other commercial payers in the market.” The healthcare network, which includes Central Washington Hospital and the Wenatchee Valley Clinics, said it informed Premera of the decision on April 23.
“We did not take this decision lightly,” Confluence Health new CEO Dr Doug Wilson said in a press release. “As a not-for-profit health care system, we must remain good stewards of the resources we have. Accepting the current terms proposed by Premera would not allow us to do so and could ultimately result in a decrease in the availability of essential health services in the region. “
Confluence says the contract was negotiated for months before its board of directors decided to break the contract, and that there are no more meetings scheduled between the healthcare provider and the insurer. Premera spokeswoman Courtney Wallace said the company believed a new contract could still be negotiated.
“We are confident that we can come to an agreement with Confluence that provides the people we serve with affordable, high-quality health care,” Wallace said in an email to NCWLIFE. “Despite Confluence’s decision to end trading, we believe it is in the best interest of our clients and the community to continue these critical conversations as this type of discussion takes time and is not a sprint. . “
The separation will take effect on February 1. Patients covered by Premera plans after that date would be considered off-grid, and their personal costs for medical services in Confluence could be significantly higher.
Wallace says Premera insures about 40,000 people and employers in Chelan and Douglas counties. She said it is wrong that Premera refused to offer competitive rates for Confluence Health, and pointed to Confluence’s stature in NCW and its lack of significant competition for patients.
“On average, Confluence Health’s hospital costs are higher than any other system in Eastern Washington. There are 12 other health plans that compete aggressively with us in the market. “
Confluence says it has decided to give six months’ notice to allow time for affected patients, insurance brokers and employers “to consider their health care benefit options and to take advantage of upcoming enrollment periods to make those important decisions about their health care coverage ”.
Confluence Health is the non-profit organization of Central Washington Hospital and Wenatchee Valley Medical Center, as well as clinics in Omak and Moses Lake. It employs around 3,000 people.
Premera Blue Cross holds the second largest market share of all health insurers operating in Washington, at 11.87% in 2020, according to the office of the insurance commissioner in Washington. Only Molina has a larger share, at 13.47 percent.