Saint Alphonsus and Regence negotiation update

December 04, 2018
By Regence

***UPDATED FEB. 12, 2019***

On behalf of our members, Regence BlueShield of Idaho works with doctors, hospitals and other providers to negotiate fair contracts that help control costs and increase care quality for communities across Idaho. Patients and their families should never be put in the middle of this normal course of business.

Since fall 2018, Regence has actively worked with Saint Alphonsus Health System on new contracts to keep its hospitals and facility services in network. Despite ongoing negotiations, Saint Alphonsus chose to terminate its current contracts in Idaho and is threatening to leave the Regence network after April 14, 2019.

Our existing contracts are evergreen, yet Saint Alphonsus chose to end them even as negotiations continue, creating uncertainty and unnecessary disruption for members. Saint Alphonsus continues to demand unsustainable rate increases that would drive up health care costs.

As a local health plan advocating for Regence members, we cannot accept the rate increase demands from Saint Alphonsus, which is one of 94 hospitals operated by Michigan-based Trinity Healthcare.

Below is important information about Saint Alphonsus and Regence:

  • The following hospitals and facility services will be out of network after April 14, 2019, if Saint Alphonsus chooses to leave the Regence network: 
    • Saint Alphonsus Regional Medical Center – Boise
    • Saint Alphonsus Medical Center – Nampa  
    • Treasure Valley Lab 
    • Saint Alphonsus Urgent Care – all locations 
    • Saint Alphonsus Health Plazas – all locations  
    • Saint Alphonsus Rehabilitation Services – all locations 
    • Saint Alphonsus Eagle Emergency 
    • Saint Alphonsus South Nampa Emergency 
       
  • Saint Alphonsus Medical Group and Saint Alphonsus Health Alliance physicians (medical groups) are on separate Regence contracts and not included in current negotiations. 
     
  • Regence members may continue to receive in-network care from Saint Alphonsus hospitals through April 14, 2019. Should Saint Alphonsus choose to leave the Regence network, care received on or after April 15, 2019, will be out-of-network and cost more out of pocket.
     
  • For Medicare, CMS regulations ensure Saint Alphonsus can only bill Medicare members for the applicable cost share for covered services and cannot be billed beyond 100% of the Medicare allowed amount. For this reason, if Saint Alphonsus chooses to leave the Regence network, we will continue covering Medicare Advantage members with in-network benefits through Dec. 31, 2019.
     
  • Medigap members are not affected by ongoing contract negotiations as they can use any hospital or health care provider that is contracted with Medicare.
     
  • Members who would like to learn more about in-network provider options should call us at the number on the back of their Regence member ID card or visit regence.com.

We are committed to continue negotiations with Saint Alphonsus and remain hopeful that an agreement can be reached that avoids unnecessary network disruption for Idahoans. Our top priority is to ensure Regence members are fully informed and supported regardless if Saint Alphonsus chooses to leave the Regence network.

We will update this page as negotiations continue. Thank you for your support.

Share: