Hood River County has found itself in a bit of a quandary after Providence Health Services elected to end its contract with the county’s health plan provider.
Last month, Providence announced it would be terminating its contract with Health Net effective Dec. 31.
That decision means that all participants in a Health Net plan would pay out-of-network prices for Providence providers on Jan. 1, 2013.
“We have some employees who are pretty steamed about it,” said County Administrator David Meriwether.
The decision affects all but a few southern Oregon counties and puts Hood River County and other county Health Net plan members in a tough spot.
If it continues its relationship with Health Net, county employees would wind up paying out-of-network costs for Providence care, try to negotiate a new deal with Health Net where the insurer would pay a greater percentage of out-of-network care costs or find a new health plan provider.
According to the Lund Report, a publication covering health care issues in Oregon, Health Net had reached out to Providence in an attempt to get the health care provider to reconsider its position.
However, it appears those discussions did not get anywhere.
“Providence’s decision was unexpected but we are moving ahead with plans that this will take place the first of January,” said Health Net spokesman Brad Keiffler.
In a statement, Providence of Oregon said the decision was “prompted by health care reform taking place nationwide, and the changes reform is generating within Providence and other health systems.”
"Our contract with Health Net will end effective Jan. 1, 2013," said Providence Oregon spokesman Gary Walker. "We understand that this decision has a significant impact on patients. If they decide to remain with Health Net and no longer use Providence, we are committed to handling the transition of their care with respect and compassion."
Providence is the major health care provider in the county, serving as the only hospital with affiliated care providers in fields from family practice to hospice to mental health to specialty care.
“It’s a real impact not only in terms of the hospital but also service providers; many of the providers in Hood River County are affiliated with them,” Meriwether said.
Come January no Health Net plans will be available in the county beyond those provided through Medicare, and Keiffler said Medicare PPO plans could utilize non-participating providers at a higher cost. [Update 10/22: Keiffler clarified, that all Health Net plans would be available, but that non-participating providers would likely be charging out of network rates]
Walker listed three possible options for those currently using Health Net: "Stay with Health Net and find services with another health care provider; remain with a Providence provider and pay for services at Health Net’s out-of-network rates, subject to their benefit plan; Remain with a Providence provider and change their health insurer."
Meriwether said that the county benefits and compensation committee would be meeting Wednesday to begin the process of going over the options for a health plan for next year.
Among the options considered may be the Providence Health plan, which would allow county employees to keep their current relationship with Providence physicians.
However, Providence has some work to do if it wants the county to consider that option.
“Providence submitted a proposal last year when we took bids but it was not competitive,” Meriwether said.
The County is not the only dealing with the Providence- Health Net issue.
Dan Bubb, President of phone and internet service provider Gorge Networks, said that his company has a Health Net plan and that the change drastically affect the families of his employees.
"This is a huge slap in the face to a community that has been so supportive of fund raising efforts, raising hundreds of thousands or dollars to help people get health care but basically is a check that goes directly to Providence," he said. "Gorge Networks has 30 families in our plan and nearly all will be significantly negatively impacted."
He echoed Meriwether's statement that Providence's health plan rates were not competitive.
"They are basically forcing our hands to either go with their insurance coverage or pay out of plan rates - which only hurts the employees which are residents of this community," he said.
Meriwether said he has inquired with Providence Health Services about the possibility of an extension of the coverage contract for Hood River County while the county explores its options, but has not yet heard back on that possibility.
“We either have notified or are in the process of notifying all the members who are affected,” said Keiffler. “We are letting them know that we are doing what we can to ensure they retain access to quality care and when necessary we will help them find providers.”
Keiffler said that current members of a Health Net plan can contact the numbers on the back of their plan ID card with any questions.
Providence has also set up a hotline for current Health Net members to call with questions. The number for the hotline is 855-234-2501 and is available 10 a.m. to 7 p.m., Monday through Friday.
“We’ll see where it goes,” Meriwether said. “I think we’ll be able to come up with some options.”