Blue Shield, UCLA Reimbursement Dispute Could Affect Patients
Thousands of patients at UCLA medical centers might need to pay more out of pocket or seek care elsewhere if a contract dispute is not resolved between the hospitals and Blue Shield of California by Dec. 31, the Los Angeles Times reports.
The contract negotiations also affect two physician groups.
Details of the Dispute
At issue is how much Blue Shield reimburses for care at Ronald Reagan UCLA Medical Center and the Santa Monica-UCLA Medical Center and Orthopedic Hospital.
More than 200,000 Blue Shield policyholders live within 15 miles of UCLA. About 8,000 of those individuals received outpatient or inpatient care at the two hospitals last year, and they are covered under Blue Shield PPO plans.
HMO policyholders largely would be unaffected because their physicians generally do not refer them to UCLA hospitals, according to the Times.
According to Blue Shield, the rates for services at the two hospitals are nearly twice as high as they were five years ago.
UCLA officials said that they have bargained in good faith and that they hope to reach a deal before the current contract ends (Helfand, Los Angeles Times, 12/14).
The contract dispute could have implications for other UC hospitals because the system plans to negotiate as a group when UCLA and Blue Shield reach an agreement, according to the San Francisco Business Times (Rauber, San Francisco Business Times, 12/13).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.