Saint Francis breaks silence on BCBSOK negotiations

A Saint Francis Health System executive said Friday his "pen is ready" if his counterparts at Blue Cross Blue Shield of Oklahoma agree to sign the contract parties had agreed to before the insurer unexpectedly added new terms less than two hours before a critical deadline.

An executive of the member-owned health insurer said while the parties had agreed to many of the contractual terms, there was no final agreement before the April 30 deadline. Saint Francis' characterization of those negotiations was described as inaccurate.

Jake Henry Jr., president and chief executive officer at Saint Francis, said he went home April 30 "feeling comforted that a deal had been reached" at 4 p.m. that day. A three-year contract struck in May 2018 between the Tulsa-based health care provider and the insurer that provides coverage to the largest segment of Oklahomans was set to expire eight hours later at midnight.

"This is a situation we have wanted to avoid from day one," Henry said. "I went home that evening feeling comforted ... that our patients wouldn't have to experience the anxiety of being caught in the middle of a contract negotiation that could potentially impact their relationship with the health system."

Henry said BCBSOK "unexpectedly sent new terms at 10:02 p.m." April 30 "with provisions that had not been agreed on earlier."

"The added terms materially changed the agreement," Henry said. "It wasn't a contract that I could sign. It wasn't what we agreed to just a few hours earlier."

BCBSOK officials said the parties spent "months of negotiations in good faith" in an attempt to secure a new contract. They said Saint Francis declined the final two offers before the deadline expired and rejected an offer for a short-term extension that would have allowed negotiations to continue without disruptions in service to BCBSOK members.

“We want to come to an agreement with Saint Francis. We tried for many months with that goal in mind, but we work for our members. It’s their premium dollars that they’ve entrusted us with," said Rick Kelly, BCBSOK vice president of Health Care Delivery, Provider Network Operations. "We cannot sign an agreement that could put them in financial harm."

Kelly said when the Tulsa-based network of health care providers "comes to the table with a reasonable agreement that ensures our members are protected from unexpected future costs, we’ll sign." The disagreement stems from the insurer's ability to evaluate future Saint Francis off-campus locations and reimbursement rates appropriate for off-campus or clinic locations.

While the 2018 contract expired April 30, all BCBS members will have in-network access to services Saint Francis locations, clinics and physicians during a 90-day transition period that ends July 29. BCBSOK members who are Saint Francis patients and presently undergoing treatment for a disability, acute condition, life-threatening illness or are in their second trimester of pregnancy may be covered after July 29 by Continuity of Care benefits.

The impasse will have no impact on BCBSOK Plan 65 Medicare supplement. Saint Francis doctors and hospitals will still be among the in-network providers included in those plans.

As the clock ticks toward the end of the 90-day transition, Henry indicated there is a chance Saint Francis could remain an in-network provider for all BCBSOK members. As of Friday, it appears the insurer would have to agree to the terms he "agreed to that afternoon" on April 30.

“We’ve all been through a lot this past year — our patients, health care workers and the community have had enough to worry about related to their health and wellness," Henry said. "We’re just a few signatures away from being able to put this behind us … my pen is ready.”

BCBS officials said as a member-owned health insurer, it "must be good stewards of our members' health-care dollars" by keeping "out-of-pocket expenses and premiums as reasonable as possible." Negotiating contracts with physicians and hospitals is one way to accomplish those goals.

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