Mission Health protects consumers insured on NC Health Insurance Exchange

August 15, 2017

Mission Health announced today that it has taken proactive and immediate steps to protect options for consumers who participate in the North Carolina health insurance exchange.  Specifically, Mission Health has offered to stay in-network and accept its current payment rates with no increase from Blue Cross Blue Shield of North Carolina (BCBSNC) for care provided to anyone covered by a policy purchased on the exchange.  Mission Health will honor these current payment rates – the “forever zero” approach BCBSNC has demanded – for all persons insured through the exchange for 2018 or until such time as a new agreement is reached with BCBSNC that covers all care provided to all patients.   

Mission Health made this announcement because BCBSNC is currently the only insurance company participating on the exchange in western North Carolina. Unlike employers selecting their benefit plans and seniors purchasing Medicare Advantage coverage who have multiple excellent choices available including newly revised programs from Aetna, Cigna and Healthy State, consumers evaluating their 2018 health insurance coverage unfortunately only have one choice.

“We take our responsibility as western North Carolina’s only safety net health system incredibly seriously,” said Ronald A. Paulus, MD, president and chief executive officer of Mission Health. “Our commitment goes far beyond providing nationally recognized, high quality, cost-effective healthcare to our community. We understand that those purchasing insurance on the exchange are among the most vulnerable in our region and have no alternative, so it is our responsibility to ensure that access to health insurance – a life transforming event – remains available to everyone.  By accepting BCBSNC’s “forever zero” approach for these individuals, we can help protect those who have exchange-based insurance, some being insured for the first ever time in their lives.”

The current contract between Mission Health and Blue Cross Blue Shield of North Carolina expires at midnight on October 4, 2017.  Negotiations must result in a new agreement by midnight on October 4, 2017, for Mission Health to remain in the BCBSNC network for all consumers, including those covered by policies purchased on the exchange. This announcement effectively excludes those on the exchange from being impacted by BCBSNC’s unwillingness to even speak with us about a contract critical to Mission Health’s long run survival.

Mission Health recently announced fundamentally revised agreements with Aetna and Cigna that offer new choices for local employers.  Mission Health continues to negotiate with a number of plans with the goal of increasing consumer choices on the exchange as well.