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

October 28, 2019
Lewiston Hill Snake River Idaho
By Regence

Updated Nov. 18, 2019

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. Patients should never be put in the middle of these standard business negotiations.

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 Tennessee-based owners, LifePoint Health, recently declared that it plans to leave Regence on Jan. 15, 2020, unless it receives significant rate increases for your care. Regence does not want this to happen, and we’re committed to reaching a reasonable agreement that you and your neighbors can afford.

While we work toward resolution, here’s how we’re supporting you:

  • Medicare access: Regence Medicare Advantage members who receive care from St. Joseph will receive in-network benefits through Dec. 31, 2020. The Centers for Medicare & Medicaid Services (CMS) regulations ensure St. Joseph can bill Medicare members for only their applicable cost share for covered services and cannot bill beyond 100% of the federally allowed amount, which we’ll continue to cover.
  • Emergency care: 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 coverage.
  • Continuity of care: Our goal is to ensure our members get the care they need. If we can’t reach an agreement by Jan. 15, 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. 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.
  • Customer service: Our Regence Customer Service team can help explain your benefits and alternative care options. Please call the number on the back of your member ID card.

It is our privilege to serve you and our community, and we’ll continue to advocate on your behalf for quality health care you can afford. We’ll continue to provide updates here as negotiations continue, and we remain hopeful that we will reach a fair agreement. Our top priority is to ensure Regence members continue to receive uninterrupted care and coverage.