Providence to stop taking patients insured by Premera Blue Cross

EVERETT, Wash. — Providence Health Services announced they will not renew their contract with Premera Blue Cross at the end of the year, forcing Providence patients to switch doctors or pay more.

The change also applies to Providence-affiliated health care organizations Swedish, Kadlec and PacMed. PacMed, or Pacific Medical Centers, is a group of clinics in King and Snohomish counties.

Medicare Advantage contracts will continue.

Those insured through Premera who use those providers will have to change doctors and hospitals or pay usually more expensive out-of-network charges staring Jan. 1, 2017.

More than 500,000 patients of Providence and it's affiliated community providers in Washington are insured by Premera.

The two companies couldn't agree on payment rates at Providence and the development of a quality incentive program that meets state and federal standards

Steve Kipp, vice president for Premera corporate communications, said that after months of negotiating, Providence “abruptly terminated our contract.”

Kipp said in a statement that Premera remains open to working with Providence on a new contract, if the health care provider is willing to meet the needs of their customers.

A statement from Providence Health & Services given to KIRO 7 Thursday morning follows:

We have notified Premera that we will not renew our commercial contracts in Washington for 2017. The contract end date will be 12/31/16.

This decision does not affect Premera patients using our facilities and physicians for the remainder of this year. In 2017, Providence, Swedish, PacMed and Kadlec providers will no longer accept Premera commercial health insurance. Medicare Advantage contracts will continue.

We know that not participating in Premera products will be disruptive for some patients and clinicians and we don't take this decision lightly. Our goal as an integrated delivery system is to always make the best operational decisions so we can continue providing quality health care services throughout Washington and the terms that Premera has presented us to date do not allow us to do that.

During the contract negotiations held in 2015, we reached a compromise for a short term agreement for 2016, with a commitment to execute a new agreement for 2017. Unfortunately, over the past year we've been unable to reach an agreement with Premera on the commercial contract for 2017.

There are several areas we would like to address, if we were to initiate a new contract with Premera including: rates; standard contracting terms across the system; and the development of a quality incentive program that aligns our work with the goals established at the state and federal level for advancing high quality, accessible health care.

We are disappointed we were unable to come to terms with Premera, but this does not mean it isn't possible for Providence to develop a new contract with Premera in the future.  We are communicating about this decision now to ensure our patients can make the best choice about their health care plans for 2017.

This is the extent of the information I have at this time, but I will keep you updated. We will also keep this informational website updated: www.keepprovidence.org.

Cox Media Group