Blue Shield Changes Classification of Two Hospitals in Santa Barbara County
Santa Barbara County residents who are members of Blue Shield of California health plans will soon have to pay more out-of-pocket for nonemergency hospitalizations at Santa Barbara and Santa Ynez Valley Cottage Hospitals because the insurer has changed the way it classifies the two hospitals, the Santa Barbara News-Press reports. Beginning July 1, the Blue Shield will change the classification of the two hospitals from "choice" to "affiliate." Blue Shield HMO plan members will have to contribute an additional $100 copayment per day for up to seven days for nonemergency admissions at facilities classified as "affiliate," the News-Press reports. Members of Blue Shield preferred provider organization plans will have to contribute an additional 10% copay for nonemergency admissions at facilities classified as "affiliate." Officials for Blue Shield on Wednesday said that they could not provide information on how many of its members would be affected by the classification change. However, companies with 500 or more employee would not be affected, the News-Press reports.
Elise Anderson, a spokesperson for Blue Shield, said that the insurer categorizes participating facilities based on studies of their services and costs conducted by independent hospital research companies. Classifications are based on "risk-adjusted actuarial analysis" that compares relative costs across hospitals in Santa Barbara County and Southern California, she said. "Consumers need to understand that hospitals in the affiliate category tend to have higher costs, and the affiliate rating does not mean they are getting lower-quality services," Anderson added. However, Janet O'Neill, a spokesperson for Cottage Health System, questioned the classification change, in part because Goleta Valley Cottage Hospital will retain its "choice" classification. O'Neill added, "All three hospitals continue to get the same amount of reimbursements from Blue Shield. This change only affects the (health plan) enrollees who go to the affiliate hospitals. But while the direct impact is on the enrollees, it does impact us because enrollees will now have to pay more of their money to stay at our Santa Barbara and Santa Ynez hospitals" (Zate, Santa Barbara News-Press, 5/28).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.