Healthcare Business News

Central Georgia Health System may lose Blues contract

By Beth Kutscher
Posted: April 23, 2014 - 5:45 pm ET

The Central Georgia Health System, based in Macon, is facing the loss of one of its largest commercial contracts after nine months of negotiations failed to yield an agreement on new terms.

The system, which operates the 659-bed Medical Center of Central Georgia, said it is preparing for the termination of its contract with Blue Cross and Blue Shield of Georgia. The contract is scheduled to terminate Thursday.

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Blues patients represented 14% of its receivables in fiscal 2013, which ended Sept. 30, according to its annual financial report (PDF). Other commercial payers accounted for 30%.

As the deadline neared, some patients took to Facebook to urge the hospital to work out an agreement with the insurer.

The system said it is continuing to negotiate with the Blues and will help create financial arrangements for Blues members that seek out-of-network care.

“Throughout this process, Central Georgia Health System has offered to continue substantial discounts to Blue Cross Blue Shield of Georgia in hopes of continuing our contract renewal seamlessly,” Rhonda Perry, the system's CFO, said in a news release. “However, in order to achieve optimal patient care, we must address medical inflation and substantial declines in reimbursement. We are also sensitive to concerns about future premium increases and have kept our proposals well within range for the Georgia market.”

The Blues notified members of the potential contract termination last month. In its letter, it said that Central Georgia made the decision to terminate the contract after the two sides failed to reach an agreement.

It also said it remains willing to negotiate a new contract that is “reasonable, fair and competitive and at rates that will not force healthcare costs to increase substantially for our employer groups and our members.”

Follow Beth Kutscher on Twitter: @MHbkutscher

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