UNC Health will remain in-network for patients insured by Blue Cross and Blue Shield of North Carolina for another four years, thanks to an extension of their long-standing ties announced on Wednesday.
The deal means the two sides will “continue collaboration on new ways to improve care and access for patients across North Carolina, especially in rural areas,” officials said in the announcement.
Timing-wise, the move comes as UNC Heath and another major insurer, UnitedHealth, remain deadlocked in similar negotiations.
UNC Health has warned that this could result in most of its facilities going out-of-network for UnitedHealth customers as of April 1.
It and UnitedHealth both acknowledge disagreements about the private insurer’s payments to the state hospital going forward. UnitedHealth contends that UNC Health wants “significant price hikes that would drive up health care costs by more than $570 million.”
For its part, UNC Health argues that UnitedHealth “routinely creates barriers that prevent us from receiving reimbursement for the medically necessary care we provide, including issuing frequent denials, engaging in prolonged appeals, and downgrading patient diagnoses, in an attempt to pay less or not at all.”
It also points out that UnitedHealth is a for-profit, one that for calendar 2023 reported $23.1 billion in net earnings. That’s money “used to line shareholder pockets,” UNC Health says.
For what it’s worth, Blue Cross booked net income of $203.7 million for 2022, according to an annual statement posted on the web by the N.C. Justice Center. That squares with figures reported last spring N.C. Health News’ Rose Hoban and attributed to the state Department of Insurance.
Blue Cross itself announced net income of $36.2 million for 2022. The annual statement does not appear to be on the nonprofit’s website.
Wednesday’s renewal announcement stressed that UNC Health and Blue Cross are partners of long standing, which for being uninterrupted “has provided stability and peace of mind for UNC Health patients and providers.”
Both the signing and the Blue Cross dispute take place in a broader landscape that includes:
- The State Health Plan’s decision to dump Blue Cross as its administrator in favor of Aetna;
- The General Assembly’s move last year to loosen restrictions on Blue Cross’ business, with legislative leaders and Gov. Roy Cooper agreeing the nonprofit needed bolstering against competitors such as Aetna;
- Legislators’ additional move to allow UNC Health a partial separation from the state retirement and insurance systems;
- UNC Health’s subsequent decision to hire a Blue Cross subsidiary, Brighton Health Plan Solutions, to administer health benefits for its new employees.
- And the ongoing troubles over in Asheville of Mission Health, now the property of for-profit HCA via a 2018 sale that followed a network-renewal clash with Blue Cross.