Cook County North Shore Hospital & Care Center Administrator Kimber Wraalstad is still tussling with Blue Cross Blue Shield over the new payment coding system the company is requiring as of January 1. She told the hospital board on October 24, 2014 that the system the company is proposing would put the hospital at financial risk.
Wraalstad said she sent Blue Cross a letter saying the hospital could not work with what they have proposed and said she has been asking them why they would potentially put the facility at risk.
Wraalstad said one person she talked with thought this was a way for Blue Cross to get out of the rural market. St. Luke’s President John Strange said Blue Cross is not doing well in the urban market, either. Wraalstad said maybe Blue Cross thinks getting out of the rural market would help their bottom line. The cost to Blue Cross for rural services is higher than the cost for urban care, Strange said, and the company is trying to reduce its costs across the country. He said St. Luke’s has been going through protracted negotiations with Blue Cross over its next contract as well.
County Commissioner Heidi Doo-Kirk said she received a letter from Blue Cross saying premiums would be higher because the company would have to cover more services under the new federal Affordable Care Act.
Several people at the meeting noted that in some places, Blue Cross is the only provider available under the health care exchange.
If the hospital were no longer a Blue Cross provider, people covered by Blue Cross could still get services there but it would be out of network. Board member Kay Olson said a lot of local government employees have Blue Cross insurance. Nurse Jeanette Lindgren said she thought people would go to Duluth for in-network care.
In the midst of this dispute, the Blue Cross employee insurance premium is expected to go up by 14.9 percent next year. The hospital was expected to let Blue Cross know by November 1 if its employees would be continuing their Blue Cross coverage. Administrator Wraalstad said she was exploring other options as well.
In other hospital news:
. Teresa Hanson gave a presentation on MnSure, the state’s new Affordable Care Act health insurance program. She said that people under 400 percent of the federal poverty level could get an advanced tax credit to help cover the cost of insurance premiums and that the amount a person did not pay in taxes would go directly to the insurance provider. She also said that under the Affordable Care Act, children will have dental and vision coverage. Administrator Wraalstad said that Medicare patients should not sign up under MnSure, because they are covered under another program.
The board approved a contract with MNsure to be an official provider of consumer assistance for people navigating their way through the new system.
. The board voted to participate with St. Luke’s Hospital in a new regional health care cooperative. According to the contract, the purpose of the cooperative will be “to facilitate coordination and improvement in patient care and operating efficiencies between various hospitals, clinics and other providers in northeastern Minnesota.”
Goals and activities may include applying for grants, participating in payor contracts and accountable care programs, and facilitating shared service arrangements. Each charter member will make an initial financial investment of $5,000, being held by St. Luke’s until the new organization is incorporated.
. The board approved the purchase of a new 55-pound-capacity industrial washing machine at a cost of $11,524. Administrator Wraalstad said fixing the old one would require replacing the whole drum and bearing assembly at a cost of at least $10,000.
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