MEMPHIS, Tenn. — Editor's note: This story was originally published stating Blue Cross Blue Shield of Tennessee customers would not be able to receive services at Methodist Le Bonheur healthcare facilities if a deal was not reached. That has since been corrected.
Blue Cross Blue Shield of Tennessee has been in contract negotiations with healthcare providers and hospitals in the Mid-South. That includes Methodist Le Bonheur Healthcare facilities. If a contract isn’t reached by January 1st, many patients will no longer be covered in-network at most Methodist facilities.
ABC24 spoke with a family who depends on Methodist Le Bonheur Children’s Hospital for constant care about how this impacts them.
Caring is priceless, and 11-year-old Alexis gets more than just care from Le Bonheur. She gets love.
“She loves going there. They know her, and she knows them. So, they're a part of our family,” said Starla Padgett, Alexis’ mother.
Alexis has cerebral palsy. We met her and her mother last year when Le Bonheur gifted Alexis an adaptive tricycle.
“Alexis was in the hospital pretty much the first year of her life,” said Padgett. “Alexis has a trach and a G tube. And so, we see everything from her PCP to her neurologist, you know, about her G tube. It's a list of just different specialists that we have to stay there.”
Staying may no longer be an option. Blue Cross Blue Shield of Tennessee is renegotiating their contract with Methodist Le Bonheur Healthcare. If a deal is not reached by January 1st, thousands under Blue Cross would have to pay more for out-of-network costs to use Methodist Le Bonheur for care.
“We just got this letter December 2nd. We have to December 31st. Not even a month. So why, why,” asked Padgett.
Blue Cross said with inflation, it all comes down to health care costs.
“Our customers are asking for help managing rapidly rising health care costs, and we have a responsibility to deliver. The rates at Methodist Le Bonheur Healthcare are much higher than average, which impacts what our members pay for care. We offered a new agreement that makes care more affordable. They have not accepted a contract that brings them in line with other providers,” said Dalya Qualls White, SVP & Chief Communications Officer of BCBS of Tennessee.
“So where does that leave me,” asked Padgett.
It’s a question with no answer as of yet.
“The closest Children's Hospital, we really had to go to Arkansas, or, you know, the Nashville, you know, to Vanderbilt. Those are the closest hospitals,” said Padgett. “That hurts me and I would have to wait to open enrollment even to think about changing insurance.”
Blue Cross Blue Shield said if an agreement isn’t reached, patients can still use Baptist Memorial Health Care system.
Care at the following hospitals may be impacted:
- Network S
- Methodist Le Bonheur Children’s Medical Center
- Methodist Le Bonheur Children’s Medical Center – Germantown
- Network P
- Methodist Le Bonheur Children’s Medical Center
- Methodist Le Bonheur Children’s Medical Center – Germantown
- Methodist Healthcare – University Hospital
- Methodist Healthcare – North Hospital
- Methodist Healthcare – South Hospital
- Methodist Healthcare – Germantown Hospital
- Methodist Healthcare – Olive Branch Hospital
Methodist Le Bonheur released the following statement:
Contract negotiations with Blue Cross Blue Shield of Tennessee are ongoing. Our goal is to come to a balanced and fair resolution before the end of the year, that benefits both parties and meets the needs of our system, providers, and the patients and families we serve.