Regence advocates for controlling member costs with St. Joseph Regional Medical Center

January 16, 2020
Lewiston Hill Snake River Idaho
By Regence

Updated Jan. 17, 2020

We will regularly update this blog post as negotiations with LifePoint Health continue in an effort to bring St. Joseph Regional Medical Center back into the Regence BlueShield of Idaho network. Our top priority as your local nonprofit mutual insurer is to support all those affected by this temporary network change while we work in good faith with LifePoint Health to reach a fair agreement that helps control costs while ensuring the Lewiston community can access high-quality care.

Background on negotiations:

Regence BlueShield of Idaho regularly negotiates with health systems across the state on contracts that ensure our members receive high-quality, cost-effective health care.

We have been working transparently and in good faith with St. Joseph Regional Medical Center leadership to reach a fair agreement that best serves the Lewiston community. Unfortunately, St. Joseph’s owner, LifePoint Health, has removed the hospital from our network as of Jan. 16, 2020. We disagree with this decision as it has created unnecessary disruption for the Lewiston community. As negotiations continue, we remain committed to reaching a reasonable agreement that you and your neighbors can afford.

Frequently Asked Question (FAQ)

Please read the information below and call us with questions using the number on the back of your Regence member ID card. We’re here to help.

Is St. Joseph out of network for all Regence members? What if a patient has Regence Medicare Advantage coverage?

As of Jan. 16, 2020, St. Joseph Regional Medical Center is out of network for Regence members with employer-sponsored health plan coverage. This means out-of-network benefits will apply for care received at St. Joseph on or after Jan. 16, 2020, until the provider returns to the Regence network. Not all members have out-of-network benefits, so please call us at the phone number on the back of your Regence member ID card if you have questions.

For Regence Medicare Advantage members, we will continue to provide in-network cost-sharing benefits for covered services received at St. Joseph through Dec. 31, 2020. However, the hospital may choose whether or not to provide non-emergency services.

What about emergencies and if a member needs to go to the St. Joseph ER?

In an emergency, you should always go to the nearest hospital ER whether that’s St. Joseph’s or somewhere else. Care for an emergency medical condition will be covered as in-network, though out-of-pocket costs may apply depending on your benefit plan.

What if a member is in active treatment at St. Joseph prior to Jan. 16, 2020, when LifePoint Health removed the hospital from the Regence network?

Our goal is to ensure our members get the care they need. Any member who is in an active course of critical treatment (such as radiation therapy or a third-trimester pregnancy) at St. Joseph is strongly encouraged to contact our Regence Customer Service team. We will make every effort to continue covering treatment at your current facility at the same in-network benefit amount until a safe and appropriate time when we can explore alternative options. This is known as “continuity of care” coverage. It is our sincere hope that St. Joseph would not add financial stress to those who seek appropriate care at its facility, since the provider can choose to balance bill out-of-network patients, Regence or others.

Are there other healthcare providers in the Regence network?

Our network includes many other high-quality, affordable healthcare providers who share our commitment to helping control costs for patients and their families. This includes Tri-State Hospital in Clarkston, Gritman Medical Center in Moscow and Pullman Regional Hospital in Pullman; and primary and specialty physician care from Catalyst Medical Group, Tri-State Clinics and other in-network providers.

If Regence is able to reach a fair agreement with LifePoint Health/St. Joseph, how will members be notified?

We are working hard on behalf of our members and the Lewiston community to reach a resolution as soon as possible. It is our hope that LifePoint Health will continue working with us to find a compromise that helps control healthcare costs for Idahoans. Please continue visiting this page for updates. And you can also call our Regence Customer Service team if you have questions or need additional information.

How does Regence BlueShield of Idaho help the local community beyond providing health plan coverage?

It has been our privilege to serve you and the Lewiston community for over 70 years. We are focused on protecting and improving the health of our members, building stronger and more connected communities, and advancing economic opportunities so that all Idahoans can thrive. Our nonprofit values guide our community work. Through volunteerism, investments and impactful partnerships, we're addressing critical issues related to social determinants of health, such as food insecurity through our partnership with the Idaho Food Bank. We're also partnering with health care providers to tackle the opioid crisis through education and smarter prescribing practices. Our Regence BlueShield of Idaho community report is available online and explains some of the ways we invest locally where our employees work and live. You can also look through our Regence Newsroom blog stories to learn about other ways we’re trying to make a positive difference for Idahoans across the state.