LEWISTON — St. Joseph Regional Medical Center is no longer an in-network provider for Regence BlueShield of Idaho after a deadline passed this week without the two sides reaching a compromise.
At issue is how much St. Joe’s in Lewiston charges Regence for the medical care Regence customers receive at the hospital or from its employees, which include physicians, nurse practitioners and physician assistants. The deadline for the agreement was midnight Wednesday.
Regence is encouraging its customers to seek care from other hospitals and health care providers not employed by St. Joe’s to avoid higher costs, except for emergencies.
The insurance provider has promised to continue to reimburse emergency care at St. Joe’s at in-network rates for its more than 15,000 customers in north central Idaho and southeastern Washington.
But the hospital could balance-bill Regence customers if there is a difference between the hospital’s actual cost for a procedure and what Regence determines is the allowable cost for a service, even in emergencies.
Prior to the deadline, Regence attempted to broker a temporary fix with LifePoint Health, the private, Tennessee-based hospital chain that owns St. Joe’s, but the effort didn’t go anywhere, said Lou Riepl, a spokesman for Regence, in an email.
“Lifepoint did not respond favorably to either our latest proposed contract amendment or our suggestion for a letter of agreement on a 30-day extension to avert termination,” he said. St. Joe’s reissued a statement Thursday similar to one it made earlier this week.
“In recent years, Regence has consistently charged patients more and more for their monthly health insurance premiums, while reimbursing (St. Joe’s) less each year for the care our team provides,” said Samantha “Sam” Skinner, a hospital spokeswoman. “This is unfair to patients and unsustainable for our hospital.”
What happens next is unfolding.
Regence and St. Joe’s executives had discussions on Thursday morning and plan to talk more soon, Riepl said.
The hospital was less specific about next steps.
“During this out-of-network period, we will work to minimize the impact on patients and we will continue to seek a solution that protects local health care,” Skinner said.
Elaine Williams may be contacted at firstname.lastname@example.org or (208) 848-2261.