Tuesday, March 29, 2022

Kicking UMMC to the Curb

 UMC issued the following statement. 

Blue Cross & Blue Shield of Mississippi is expected to force University of Mississippi Medical Center hospitals, clinics, physicians and other providers out of its commercial insurance network, effective April 1, 2022, as part of the insurance giant’s refusal to agree to a new contract with the state’s only academic medical center and safety net hospital.

 

The contract covering commercial Blue Cross plans, which are typically provided through an employer, ends March 31. Unless a fair agreement is reached in time, Blue Cross is expected to force UMMC out of its network effective April 1 – negatively impacting access to UMMC’s essential services and physicians. The State and School Employees’ Health Plan, which is managed by Blue Cross & Blue Shield of Mississippi, is not a part of this contract.

 

UMMC is the state’s only academic medical center, safety net hospital and home to many advanced, specialty services only available in Mississippi at UMMC. It’s essential to the health and well-being of all Mississippians that UMMC continue to advocate strongly for an updated, fair contract with Blue Cross. For many years, Blue Cross has significantly underpaid UMMC for care provided to its members. At stake is UMMC’s ability to reinvest in the health of Mississippi through research, education, advanced technology and the highly trained physicians and care teams needed to provide the best patient care.

 

UMMC provides unique services such as a Level I trauma center, a children’s hospital, an organ and tissue transplant program and a Level IV neonatal intensive care unit. UMMC treats the sickest of the sick, many of them transferred from hospitals that don’t have the specialty or advanced-level care needed for patients who are traumatically injured, critically ill, suffering from complex health problems and those with the gravest illnesses. In addition, UMMC is the state’s largest educator of specially trained health care professionals and home to the state’s emergency medical services center. UMMC – and its statewide system of more than 200 hospitals, clinics and telehealth sites – is a cornerstone of the state’s network of hospitals and health care providers.

 

On multiple occasions, Blue Cross has stated and implied through its actions that it does not value the unique role UMMC plays in Mississippi’s health care landscape.

 

“Blue Cross wants to compare us to other Mississippi hospitals, but there are no hospitals in the state that are like us. Every day we treat patients across Mississippi, many with nowhere else to turn, because they need the specialty physicians found only here at UMMC. We should be compared to other academic medical centers and safety net hospitals just like us,” said Dr. LouAnn Woodward, vice chancellor for health affairs and dean of the School of Medicine.

 

“Mississippians deserve full access to their academic medical center, and we hope that Blue Cross agrees with that and comes to the table ready to partner with us in prioritizing the health and well-being of our patients and all Mississippians.”

 

UMMC has requested a rate increase “that moves us closer to – not equal to or more than – market rates,” said Dr. Alan Jones, associate vice chancellor for clinical affairs. “It is essential that UMMC be paid in line with comparable academic medical centers in regional cities like New Orleans, Memphis and Birmingham.”

 

Blue Cross commercial health insurance members are encouraged to call the Blue Cross customer service number on the back of their membership card to voice concern over Blue Cross’ plan to eliminate UMMC doctors and hospitals from their network.

 

A dedicated phone line has been established at 601-496-0008 for anyone who has a Blue Cross commercial health plan and has questions about the negotiations. Also, information and updates about the negotiations can be found at UMMCCares.com.

 

54 comments:

Anonymous said...

At the end of the day, I know both are greedy corporate entities, but I think I dislike BCBSMS more.

Anonymous said...

BC has always tried to be the 800 lb gorilla. They need to be canceled. the most profitable non-profit of all time.

Anonymous said...

They need to get this shit fixed. Greed, on both sides, and we pay too damn much for mediocre insurance. F'BCBSMS and F'UMMC. Both of them are greedy and don't care about customers or patients on a business level(not speaking of nurses or care givers).

Ben Dover, Esq. said...

BCBS needs the savings to grease political palms, mostly in Washington, to write laws that favor the insurance industry, not the public.

Anonymous said...

Is there a justifiable reason why UMC should receive an above-market reimbursement rate for health care services that are comparable in skill, quality, and outcome to its competitors? In other words, what separates UMC from Baptist, St D, etc., when it comes to basic health care services? Now, if we are talking about Level 1 trauma services or specialized pediatrics, then I get it. But sniffles and broken bones and $hit shooting out of the @ss? Pay them the market rate.

Anonymous said...

My United Healthcare plan has already been taken out of network at UMMC. I'm having to pay out of pocket for treatment there.

Anonymous said...

@10:08, but they're the state's ONLY academic medical center and safety net hospital!

Anonymous said...

Never an issue with BCBS. I don't go to UMC.

Anonymous said...

Maybe I would take UMMC more seriously if they weren't so full of themselves and didn't write press releases to sound like marketing brochures. I'm really sick of the "only academic hospital" and "safety net hospital" diatribe as if they are more entitled than anyone else.

Anonymous said...

I am pretty sure I saw this movie several years ago

Anonymous said...

By and large, health insurance is an absolute scam, especially here in MS where BCBS and UHC are practically the only games in town.

Anonymous said...

I'm not sure who I dislike more. There's no parking at UMC and the staff isn't helpful. But, BCBS's rates are unaffordable, $1800/month for insurance.

Anonymous said...

Not the first time BCBS opted out of a government run deal. I think Hinds County was on it 20 years ago. Makes one wonder if some folks want their palms greased and BCBS is saying hell naw.

Anonymous said...

All insurance is a scam. It is gambling and the house ALWAYS wins. I don't know how the people who sell it sleep at night.

Anonymous said...

It's hard to pick a side here. I detest the greed of both insurance companies and hospitals. Pretty sick of UMC, anyway.

Anonymous said...

@11:43 AM
We sleep on the finest mattresses you’ve never heard of, with the highest thread-count linens money can by, with satin covered goose down stuffed pillows imported from France.

Anonymous said...

11:43 probably pretty good laughing at people who makes comments like yours but has to finance everything. It does seem like it to people who try and nickel and dime their coverage then complain when something isn't covered. I would like for you to explain how it is a scam. My experience is they have paid out more in my lifetime than I have paid in.

Anonymous said...

This is precisely why I have secondary insurance for my family.

Anonymous said...

"Mmmmm My elbow hurt"

Anonymous said...

I think this is another rerun. I seem to remember this all happening a few years ago. Maybe I am physic.

Anonymous said...

Dear Lord, you people understand NOTHING about insurance!!

BCBS is actually trying to SAVE people money. The higher that’s allowed the more you will owe for the service.

This article is regarding CORPORATE plans… meaning YOUR EMPLOYER sets the terms, copays, deductibles, co-insurance, etc…. NOT BCBS.

With these type plans, BCBS is only paid to ADMINISTER the plan. Your employer collects premiums and uses that money to help fund what is paid to your providers.

Now, if you wanna talk about those DIRECTLY insured through BCBS, that’s another story. BUT, this article is about corporate plans. Just because you have a BCBS card, doesn’t mean you’re directly insured through them. Most folks are insured by their EMPLOYER.

Anonymous said...

UMMC said:

"We
GONNA
WAR."

Greatest line from any movie.

Anonymous said...

From my BCBS rep, this only applies to FED VIP members and state BCBS is still going to be accepted. If the contract is not agreed to by end of March, FED VIP are covered until June 2022. Then you can submit a direction of payment to information BCBS to pay UMMC even if they are out of network. That's what I was told this morning from the BCBS side.

Anonymous said...

I challenge everyone who thinks BCBS dictates the terms of their insurance at work to go to your HR manager and ask who REALLY makes the decisions regarding your medical insurance. (Hint: It's NOT BCBS.)

You'll find your employer isn't outraged by this because, in the end, IT KEEPS YOUR EMPLOYER FROM PAYING MORE FOR YOUR MEDICAL SERVICES. Oh, the manager may try to save face and be empathetic while looking at you, but if they're honest, they'll tell you the company supports BCBS' fight.

And no, I do not work for BCBS (although I did have a short blip there after college about 30 years ago.) I just can't stand the ignorance about how insurance actually works.

Anonymous said...

UMC is a shitshow and has been gouging billions for years (and getting over a billion a year in state funding on top of that). All things out of Oxford think they drive the train...

BCBS just finally shrugged and told them, "Those who have the gold, make the rules." Bye LouAnn. Long overdue.

Anonymous said...

"I think this is another rerun. I seem to remember this all happening a few years ago. Maybe I am physic."

Somebody can't spell.

Anonymous said...

The doctors comprising the Front Line COVID-19 Critical Care Consortium developed the I-MASK Protocol (at home and early treatment), the MATH Protocol (in hospital treatment) and the I-RECOVER Protocol (recovery, long-COVID) while the Dobbs, MS Dept. of Health and UMMC gave us the UMMC POP Protocol (profits over patients). "Go home and drink water until you cant breathe, then return to the ER, Remdesivir, Ventilator, Death. I'm not going back to that shithole even if it's free.

Anonymous said...

@12:44: Yeah, I think you are physic.

Anonymous said...

If you want the "Bad Guy" it is LouAnn. She ooooozes all things not cool.

Hookah said...

My health insurance functions more like a Groupon - saves me like 7% on medical costs.

Anonymous said...

1:15 ... truth, thank you. I wouldn't take a stray dog to UMMC. Wonder why they don't provide a break down of who died 'with' or 'from' covid? How much money did they pocket? Those people will lie to Jesus looking him in the eyes.

Anonymous said...

Can’t spell BCBS without the BS. I’m so sick of getting ripped off by those middlemen asshole salesmen.

Anonymous said...

“Yeah, I think you are physic.”

These are the people who voted for Mayor Lumumba, and you’ve a a problem with him?

Pure comedy.

Anonymous said...

10:08 is right. UMMC shouldn’t be paid any more than Baptist/St. Dominic’s/et Al, for any particular procedure, simply because they do all this other stuff (which I admit is important stuff). Those costs need to be accounted for and paid elsewhere—State of MS, other patients, drug companies, other health care providers…

Anonymous said...

I know each person has a different situation, but several years ago I received specialized treatment for an acute cancer. UMMC was the only place in MS that I could receive this treatment. It was successful and my caregivers were awesome. My State of MS insurance administered by Blue Cross paid very well—much, much more than I ever paid in premiums. You never know when you might be stricken with an unusual disease. Receiving treatment at UMMC kept my family from having to deal with costs and inconvenience of treatment out of state.

Anonymous said...

Doctor services are paid by CPT codes. UMC wants blue cross to pay their docs 1.5 times for the same code as they pay other docs. This is insane. The docs in town do it faster and better. At UMC students and residents are working on you. The hospital costs are much more at UMC because of the inefficiency of doctors in training

Anonymous said...

Funny that a nonprofit goes to court to keep their income from dear old BCBSMS from the public, oh btw that’s only applies to upper mgt. don’t believe me google it,makes for interesting reading!

Anonymous said...

Best thing for Mississippians would be for UMMC to walk out on BCBS and NEVER go back. BCBS is, for all practical purposes, a monopoly in our State and needs to go the way of Mah Bell.

Anonymous said...

How will this affect UMMC building on Highland Colony?

Anonymous said...

It sucks that health insurance is tied to an employer. The whole system needs to be overhauled before it bankrupts us, but the politicians are getting paid too much for there to be any real changes.

Anonymous said...

Blue Cross is focusing on preventative care as the future model of healthcare - UMC likes making lots of money on "treating the disease" only and doesn't want to change from their medical model that is outdated...and as they're finding out - unsustainable.

Anonymous said...

"BC has always tried to be the 800 lb gorilla. They need to be canceled. the most profitable NON-PROFIT of all time."

Of all the states where I have practiced, Mississippi has the only FOR-PROFIT BC/BS company I have ever encountered. It is also the worst, and can mainly be explained by stupidity and greed.

Anonymous said...

@ 9:35 - "At the end of the day, I know both are greedy corporate entities..."

Nope. UMMC is a university, not a corporation.


@ 11:18 - "It sucks that health insurance is tied to an employer."

That's a choice. You can buy whatever health insurance you want at whatever price the insurance company will sell it to you for. Just like tires.

Anonymous said...

8:38 has it nailed. This is about LouAnne trying to strong arm BCBS into paying her and her doctors more money while other employees after insurance and retirement comes out can't feed themselves.. She indicates this everytime she is in front of the media. "We are different....we are special".

Anonymous said...

@9:25a- Boy, you REALLY don’t understand how work-related insurance works.

If you employer offers health insurance, you can’t just prance over to private health insurance. There are lots of rules and issues that could potentially affect the premiums paid being taxable or non-taxable for you and/or your employer. You definitely cannot get the touted Marketplace insurance if your employer offers health insurance. So, no, it’s not as simple as driving to a different tire shop.

Again, I’ll repeat for all the genius commenters who think this has ANYTHING to do with BCBS’ profits. The issue in this column saves the insureds (YOU) and your employers money. BCBS is pocketing NOTHING from keeping the allowed covered amounts lower. Why is this so hard for people to comprehend??

Anonymous said...

"Nope. UMMC is a university, not a corporation."

The clinical practice plan, i.e. the high-paid medical doctors, are a corporation (unless things have changed).

Anonymous said...

March 29, 2022 at 7:46 PM
Sincerely very happy for you that your treatment was successful.

Regarding "Receiving treatment at UMMC kept my family from having to deal with costs and inconvenience of treatment out of state."
Sadly no longer the case. Friend diagnosed with cancer was turned away with BCBS at UMMC. Now family is having to travel to Birmingham for treatment!

Anonymous said...

@1:27pm So you're saying your friend got screwed by UMC?... because UMC chose not to provide them treatment at their facility, and at a reasonable rate? UMC SUCKS!

WTF!

Anonymous said...

@1:27 the contract hasn’t expired yet. if your friend was referred to another facility it had nothing to do with her insurance.

what are you people, on dope?

Anonymous said...

I cannot believe this is happening again. UMMC being greedy and then BCBS also trying to fatten up their profit margin. Sad thing is that the little guys are the ones who get screwed over by this ridiculous infighting.

Anonymous said...

10:18, friend was refused treatment at UMMC directly due to their BCBS insurance! You are the one on dope. How ridiculous of you to even comment.

Anonymous said...

10;29 is correct , however BCBS has the entire mississippi legislature on its payroll in order to maintain their monopoly in mississippi

Anonymous said...

health insurance companies like BCBS are complealtly exempt from from federal anti competitive laws. have been since the late 1940s. how much money , hookers and booze did the lobbyists spend in washington to get that one pushed through?
done take my word for it ....look it up.
they also share information with each other in order to collude and to keep premieums as high as possible.

Anonymous said...


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