Blue Cross, Sutter Reach Two-Year Agreement
Ending a nearly three-month contract impasse that forced thousands of Californians to choose between their doctors and their health plan, Blue Cross of California and Sutter Health yesterday announced a two-year agreement retroactive to Jan. 1, the San Francisco Chronicle reports. While the dispute centered on reimbursement rates, neither side disclosed the terms of the new contract, citing proprietary concerns (Colliver, San Francisco Chronicle, 2/21). However, the two companies did announce that their agreement includes a "groundbreaking patient protection provision" that would allow Blue Cross patients to continue seeing Sutter physicians for six months with no extra fees "[i]n the event of a future negotiating impasse," the Sacramento Bee reports. The provision departs from the current "industry standard of 30 days' transition coverage that applies only to pregnant women and the chronically ill" (Rapaport, Sacramento Bee, 2/21). That standard left thousands of Blue Cross consumers without regular access to Sutter's 27 Northern California hospitals and seven affiliated physician groups when the two companies' contract expired on Jan. 1.
Discussing the agreement, Blue Cross spokesperson Michael Chee said, "Concessions were made on both sides, but the terms were reasonable." Sutter spokesperson Bill Gleeson said, "The contract meets our parameters around competitive rates and contract rates" (San Francisco Chronicle, 2/21). He added, "We very much regret the disruption and the problems that this [dispute] caused. We only hope our patients who are Blue Cross members appreciate our predicament and our need for a fair contract" (Feder/Walker, San Jose Mercury News, 2/20). Daniel Zingale, head of the Department of Managed Health Care, said, "It's encouraging to see agreements can emerge when the situation appears to be almost hopeless. It's good the agreement came, but it's a shame it took so long" (San Francisco Chronicle, 2/21). Because the contract is retroactive, Blue Cross will have to sort through claims filed by members who used Sutter providers since Jan. 1 and reimburse them according to the provisions of the new agreement (Metinko, Contra Costa Times, 2/21).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.