Vermilion group calls on OSF, Blue Cross to settle differences

Vermilion group calls on OSF, Blue Cross to settle differences

DANVILLE — A Vermilion County business group is urging OSF HealthCare and Blue Cross Blue Shield of Illinois to settle their differences without further delay.

The lack of a contract between Blue Cross Blue Shield and OSF covering Danville's only hospital is having a huge impact on employer groups in the area, according to Vicki Haugen, president and CEO of Vermilion Advantage.

Both the former Presence United Samaritans Medical Center in Danville, now OSF Sacred Heart, and the former Presence Covenant Medical Center in Urbana, now OSF Heart of Mary, exited the Blue Cross Blue Shield network after OSF became their new owner on Feb. 1.

A Peoria-based Catholic health system, OSF has been in negotiations with Blue Cross Blue Shield to bring the Urbana and Danville hospitals back into the insurer's network, but the two have yet to come to terms on reimbursement rates.

"As you are, no doubt, both aware, Blue Cross Blue Shield is a major provider of health insurance in our market," Vermilion Advantage said in a letter to Blue Cross Blue Shield of Illinois President Maurice Smith and OSF HealthCare CEO Bob Sehring on behalf of its 520-plus business members. "We have been inundated with calls and emails of concern since the Feb. 1 acquisition due to these unresolved issues that impact so many."

This has become a frightening situation for many people, some of whom have had to cancel planned procedures at the Danville hospital, Haugen said.

While she doesn't know how many employer groups in the Danville area selected a Blue Cross Blue Shield health plan for this year, she believes the percentage is significant. A 2017 survey done by Vermilion Advantage found 65 to 70 percent of employer groups in the Danville area either chose Blue Cross Blue Shield for their health coverage or considered an offer from that insurer, she said.

Some employers now feel deceived, Haugen said. They felt secure in signing contracts with Blue Cross Blue Shield believing that insurer had ironed out its differences with OSF HealthCare based on an announcement in November that a deal had been reached to keep OSF hospitals in the insurer's network. What local employers didn't know, Haugen said, was that the Urbana and Danville hospitals OSF was set to buy weren't included in that deal.

"There is nothing more personal, emotional and many times frightening than dealing with health care needs and concerns," the Vermilion Advantage letter goes on to say. "To have this major change in control of our local hospital with such a huge unknown remaining does not begin a new community relationship on a positive track. Likewise, the inability for one of the state's largest health care insurers to appear to have no urgency in finding a resolution with a provider with whom you already have contracts and relationships perpetuates the national perception of profit overshadowing customer service and goodwill."

The Danville business group further contended that Carle's two hospitals in Urbana and Hoopeston aren't a consolation, "since both these institutions are 30-plus miles from the Danville-area customers you both are both supposed to be serving."

To date, OSF HealthCare has reached contract deals with 30 health plans for the two hospitals among several insurers, including Health Alliance Medical Plans and Aetna, keeping the Urbana and Danville hospitals in network for their members, according to OSF spokeswoman Shelli Dankoff.

Along with Blue Cross Blue Shield, OSF has yet to secure a contract with HealthLink.

"We're very frustrated," Dankoff said.

OSF's latest proposal went to Blue Cross Blue Shield nearly a week ago, and the insurer hasn't responded yet, she said.

OSF has contended Blue Cross Blue Shield won't pay reimbursement rates that are competitive with what it pays the system's other hospitals or with what other insurance carriers in Urbana and Danville are paying.

Blue Cross Blue Shield of Illinois spokeswoman Dana Holmes said an issue concerning the two hospitals came to a head with the change of ownership, because OSF wouldn't take over the contracts of the hospitals' previous owner, Presence Health. OSF could have kept those contracts in place but chose to negotiate new terms, she said.

"We're still in discussions, and we have every intent to reach a positive outcome for our members and our clients," Holmes said.