It’s the biggest health insurer of Stateline residents and it just made a big change. Blue Cross Blue Shield says it will now change medical providers, from OSF St. Anthony to Mercyhealth.
“Blue Cross did put us, we feel, in a difficult situation, to have to terminate the remainder of the hospitals,” said Ryan Billings, OSF Healthcare Senior Vice President of Population Health.
It means OSF will no longer accept Blue Cross/Blue Shield insured patients in their facilities, after January 1st. The decision came as a surprise to OSF hospital leaders.
“We were in multiple meetings that week,” said Billings. “It was frankly shock, and we’re disappointed that Blue Cross has done this.”
Blue Cross patients will still be covered for visits under OSF’s physician’s group, which include services like neurosurgery, cardiovascular and children’s care. However, what is not covered are inpatient and outpatient services. Those will now be accepted at MercyHealth facilities.
“I think Blue Cross just realized that they needed to have that new regional referral hospital in Blue Cross networks,” said Javon Bea, President and CEO of MercyHealth. “So, that way, it would be considered an in-network hospital for its subscribers.”
Bea says MercyHealth’s big expansion, including the new major facility on Riverside Blvd., were factors in Blue Cross’s decision. While many Blue Cross patients will have to switch doctors, they’ll have teams working with employers to smooth the transition.
“I think Blue Cross saw that MercyHealth proves the most comprehensive health service for this regional area.”
Blue Cross did release a statement, saying OSF, “no longer serves Blue Cross Blue Shield’s aim to continue to broaden members’ access to network providers.”
Blue Cross Blue Shield patients can speak to their employers about benefit options and questions.