BLUE SHIELD: Marshall Hospital Threatens to Drop Insurer
Citing a $5 million shortfall this year, Placerville-based Marshall Hospital plans to end its 14-year relationship with Blue Shield of California if the insurer cannot provide the hospital with a satisfactory rate increase, the Sacramento Bee reports. Marshall CFO Jim Whipple said that Blue Shield currently reimburses Marshall for slightly more than 20% of inpatient treatment charges; a rate which has not increased in four years. In response, the hospital demanded a 139% hike in inpatient charges from Blue Shield, but the insurer countered with a much smaller increase. "From our vantage point, they were asking for a pretty significant one-time increase," Robert Geyer, Blue Shield's vice president of provider relations, said. He added, "We understand the pressures on hospitals, and we're more than willing to negotiate reasonable reimbursement rates." The insurer represents about 5,500 El Dorado County residents, and while members would retain current benefit levels and could still be treated at Marshall, their out-of-pocket costs would "increase substantially," Geyer said. With the current contract set to expire on May 22, both parties remain hopeful about reaching an agreement (Fisher, 4/28).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.