Saint Alphonsus and Regence negotiation update

December 04, 2018
By Regence

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

Saint Alphonsus recently mailed letters to our Medicare Advantage members that included false information with only days remaining in the 2019 Medicare Annual Enrollment Period (AEP). This has created widespread and unnecessary confusion, considering that until this point, negotiations have focused on the commercial hospital system, and not on Medicare.

We strongly disagree with Saint Alphonsus’ decision to create uncertainty and concern by going public with our negotiations. Please know that we are here to support our members as we work to resolve this issue.

No one benefits from Saint Alphonsus raising alarm over a contract that is being actively negotiated ahead of its possible 2019 expiration date. It is unfortunate that Saint Alphonsus is putting Regence Medicare members in the middle of standard negotiations.

Below is important information about Saint Alphonsus and Regence:

  • From the outset, our focus has been on setting rates with Saint Alphonsus Regional Medical Center (Boise and Nampa) that are closer to market and comparable to nearby high-quality health care providers in the Treasure Valley.
  • Saint Alphonsus is proposing rates that, if accepted, would be the highest in Idaho and lead to higher premiums and costs for Regence members.
  • Working on behalf of our members, employers and broker partners, we cannot accept the rate increase demands being made Saint Alphonsus, which is one of 94 hospitals operated by Michigan-based Trinity Healthcare.
  • For Medicare, the Centers for Medicare & Medicaid Services (CMS) provide additional protections for balance billing, so we can continue covering in-network benefits for our Medicare Advantage members through Dec. 31, 2019, regardless of whether Saint Alphonsus Regional Medical Center chooses to leave our network.
  • We remain committed to continuing our discussions with Saint Alphonsus in hopes of reaching a resolution.
  • We proudly contract with other hospitals in the Treasure Valley that share our commitment to delivering high-quality and affordable care should Saint Alphonsus Regional Medical Center choose not to reach an agreement by March 31, 2019.
  • 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 will update this page as negotiations with Saint Alphonsus continue.

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