Blue Cross, HCA Agree on Contract for Three Southern California Hospitals

Blue Cross of California late yesterday announced a "partial agreement" with HCA over a new contract with three hospitals in Southern California, the Los Angeles Times reports. Contracts with the hospitals, which include Thousand Oaks-based Los Robles Regional Medical Center, West Hills Hospital and Medical Center and Riverside Community Hospital, expired Oct. 1, leaving tens of thousands of Blue Cross members without coverage for hospital services except emergency care. Blue Cross spokesperson Michael Chee did not disclose the terms of the new contracts, and HCA officials did not comment, the Times reports. Blue Cross and HCA have not reached agreement over contracts with three hospitals in San Jose (Lee, Los Angeles Times, 10/23). Last week, HCA launched a series of advertisements that asked Blue Cross members to switch health plans to allow them to continue to receive care at the San Jose hospitals, which include Good Samaritan Hospital, San Jose Medical Center and the Regional Medical Center of San Jose (California Healthline, 10/16). Blue Cross officials had offered HCA a contract that included a 50% increase in reimbursements over two years, but HCA rejected the offer. An HCA spokesperson said that the offer was the "lowest of all insurers" and was "insufficient to cover the cost of medical services," the Times reports. The companies plan to resume negotiations on the San Jose hospital contracts today (Los Angeles Times, 10/23).

The contract dispute between Blue Cross and HCA could "cause severe problems" in patient care and "underscores the heightened tensions between insurers and hospital companies" that result from increased health care costs, the Times reports. Blue Cross will continue to cover the cost of emergency care and the cost of "ongoing or previously scheduled services" through the end of the month, but tens of thousands of members have lost coverage for most services at their local hospitals. HCA-owned Hospitals throughout the San Fernando Valley and Ventura and Riverside counties have delayed medical tests and elective surgeries and have diverted patients to other facilities. In addition, although other hospitals often could provide adequate care, many areas have a shortage of hospital beds, and many hospitals have "increasingly become specialized" and cannot treat certain patients, the Times reports (Lee, Los Angeles Times, 10/23).