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Contract dispute between Blue Cross Blue Shield, UMMC could leave tens of thousands paying more for health care

Published: Mar. 29, 2022 at 9:11 PM CDT
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JACKSON, Miss. (WLBT) - A showdown between a major insurance provider and the state’s largest hospital has erupted over how much should be paid for patient care, a stalemate which could leave tens of thousands of Mississippians to pay much more for critical health care needs.

“The biggest impact of this negotiation and us going out of network is going to be access to care that only UMMC provides to patients in the state of Mississippi,” said Dr. Alan Jones, who serves as the University of Mississippi Medical Center’s associate vice chancellor for clinical affairs.

That negotiation, Jones said, fell apart recently, after UMMC and Blue Cross Blue Shield of Mississippi had been going back and forth since January.

“We believe that we are underpaid compared to other academic medical centers, what market data would show significantly, maybe even 70 to 80 percent?” Jones said. “We’re not even trying to make up half of that difference. We’re just trying to get to a point where we think it is a fair starting point. So numbers wise, we’re about 30% off in the difference that we are asking compared to what they’re offering.”

In a lengthy statement, Blue Cross Blue Shield of Mississippi spokesperson Cayla Mangrum called UMMC’s press release “full of inaccuracies and misleading statements,” blaming the hospital for not renewing its agreements and cancelling agreements with its physicians two months ago.

Jones said part of the reason they’re paid less is because BCBS considers UMMC like every other hospital in the state.

The state’s flagship hospital is the only level one trauma center in Mississippi, has the only children’s hospital in Mississippi and is the only hospital that houses a transplant center, Jones said.

“Hospitals around us and in this state vote with their feet every day. We accept up probably more than but at least 30 to 40 transfers from other hospitals every day. That tells us that other hospitals view us as a different level of care,” Jones said. “They think we have a service that they need that they don’t have.”

Mangrum fired back that UMMC wants its physicians to be paid more than others in the state, and said the facility doesn’t want to be measured against other hospitals... but rather against itself based on fewer expectations of quality.

If an agreement isn’t reached by April 1, most who get BCBS of Mississippi through their employers will no longer get in-network coverage if they choose UMMC or its affiliated clinics statewide.

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