UMMC, Blue Cross end contract dispute

JACKSON, Miss. — Mississippi’s largest private insurer and its largest hospital have reached a new contract, meaning patients covered by Blue Cross & Blue Shield of Mississippi can resume seeking care at the University of Mississippi Medical Center at in-network rates.

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The insurer and hospital announced Friday that the medical center had returned to being in-network as of Thursday. The announcement, in a three-paragraph statement, left unanswered whether the hospital or insurer came out on top in their struggle over how much the medical center should be paid.

“Blue Cross and UMMC remain focused on their missions of serving Mississippians’ healthcare needs,” the statement said. “The terms of the contracts are confidential.”

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The medical center has long argued that it’s being underpaid by Blue Cross compared to similar hospitals in other states. The medical center is Mississippi’s sole provider of some medical specialities, including the state’s only top-level trauma center and its most capable neonatal intensive care unit. Other hospitals in much of the state routinely transfer patients with the most complex conditions to the medical center’s flagship complex in Jackson.

Blue Cross, though, has said paying the medical center at the rates it demanded would cause customer premiums to rise.

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The hospital and insurer have also squabbled over how Blue Cross pays hospitals for quality outcomes.

The yearslong dispute blew up again on April 1, when the medical center parted ways with Blue Cross. Patients covered by the insurer could still see medical center-affiliated providers, but most faced higher costs. Some patients reported putting off surgeries, while others traveled out of state.

Dr. Alan Jones, associate vice chancellor for clinical affairs at the medical center, urged medical center faculty members to help reestablish relationships with Blue Cross policyholders, according to a memo obtained by the Northeast Mississippi Daily Journal.

“We understand that the past several months have been difficult and I appreciate the work our clinical departments, care teams and support staff have done to assist impact patients,” the newspaper reported.

State Insurance Commissioner Mike Chaney said in a statement that he was thankful the two entities overcame their differences and returned affordable healthcare to 750,000 policyholders.

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“I sincerely hope that UMMC and [Blue Cross and Blue Shield of Mississippi] will now move forward in a collaborative relationship to provide innovative, accessible and affordable healthcare in our State and will put patients and policyholders as their first priority,” Chaney said.

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Both sides battled for public favor with advertisements and billboards. In July, Blue Cross & Blue Shield sued three medical center officials for defamation, including Vice Chancellor and Medical School Dean Louann Woodward, Jones and spokesperson Marc Rolph. The insurer said their public statements made it appear that the insurer dropped the medical center from its network when the insurer said it was the medical center that ended agreements with the insurer.

It wasn’t immediately clear if the insurer would drop the lawsuit.

The dispute could lead to increased regulation of insurers. Chaney has proposed that lawmakers block contracts between insurance companies and healthcare providers from being canceled outside of a 90-day window before an open enrollment period.

The hospital also lost $50 million in federal COVID-19 relief funds that it planned to use for capital improvements to its adult hospital and operating rooms after Republican Gov. Tate Reeves vetoed the appropriation in April. Reeves said at the time that the state shouldn’t “further subsidize the operations of UMMC to the detriment of competitors” when the hospital was “willingly” turning away Blue Cross patients.


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