Regence responds to The Oregonian and for-profit dialysis companies

By Regence
October 30, 2015

Regence BlueCross BlueShield of Oregon, a local not-for-profit company, has a long history of caring for its members and providing them with the support they need – when they need it. That includes members who have End-Stage Renal Disease (ESRD) and require either dialysis treatment or a kidney transplant to stay alive.

Recently, Oregon state Sen. Chip Shields (D-Portland) and Rep. Andy Olson (R-Albany) suggested that Regence is discriminating against patients with ESRD. This is not only false but also mischaracterizes the work our company does on a daily basis to support our members and ensure they have the peace of mind in knowing we stand behind them.

Regence provides comprehensive benefits to its Oregon members, including those with ESRD -- $20 million in care annually. In addition, we provide licensed nurses to support our members from the point of diagnosis through dialysis treatment, kidney transplant and recovery.

Regardless of their insurance, anyone with ESRD is eligible for additional Medicare benefits after about three months of dialysis treatment. Since 1972, the federal government has provided health care coverage for ESRD patients under the Medicare ESRD program no matter their age or financial circumstances.

Our members can choose to enroll in additional Medicare benefits for ESRD while remaining Regence members. It’s their choice. If they decide to enroll in Medicare, their out-of-pocket costs may be lower and they can still visit a wide range of dialysis centers for their treatment.

At its core, this is not about coverage or Medicare, but the rates national for-profit dialysis companies demand. Despite repeated attempts, we’ve been unsuccessful in signing a contract with the two dominant dialysis companies that would result in reasonable rates for our members.

We are disappointed that Sen. Shields and Rep. Olson are trying to make this about our care for our members while neglecting the real issue. In Oregon, more than 85 percent of the dialysis centers in our network are owned or controlled by two major for-profit companies that have a combined net income of $1.5 billion in 2014 and nearly $25 billion in sales and revenue.

Medicare limits what these corporations can charge. People with private insurance pay 7 to 10 times more than Medicare for the same services. That’s why we’ve designed our benefits to protect our members. It’s the right thing to do.

The Oregonian has previously recognized these huge cost surges, documenting in 2011 that the same two dominant dialysis companies billed the state insurance pool $300,000 per patient per year vs. $82,000 for Medicare.

The question Sen. Shields and Rep. Olson should be asking is why Oregonians’ choice is too often limited to just one or two major for-profit dialysis companies and why there isn’t more competition or choice? And what do the dialysis companies stand to lose in terms of profit if insurers and their members fight back against egregious prices for care?

Regence is a local company with a commitment to serving our members and the Oregon community. To suggest that our business practices are anything less than ethical is inaccurate and wrong.

We encourage The Oregonian to continue the work it began in investigating these national dialysis corporations and revealing the true motives in this story. Our citizens deserve and expect a fair look at this critical issue.