Opinion: Big Insurance introduces a Big Mess in Tennessee

Healthcare in our country is a complex system, but is still the best in the world. We have the best access to care, the best treatments, and we’re finding new and better ways to help provide care for our patients.

Unfortunately, there could be drastic changes to our healthcare landscape very soon, resulting in restricted access to care for patients in the Memphis and Mid-South communities.  This is in large part due to the recent actions by Blue Cross Blue Shield of Tennessee (BCBST) to send contract termination notices to several physician groups and healthcare facilities in the Mid-South.

BCBST is demanding that a number of physician groups and healthcare facilities either accept drastic rate reductions or go out of network.  These rate reductions, in some cases, equate to a 40% cut or more to healthcare providers.

Our groups received this information by way of an impersonal form letter demanding our practices accept a whopping 40% rate reduction. BCBST did this with little notice and no legitimate justification. They demanded our physicians, nurse anesthetists, and nurses take these drastic cuts. Recruitment and retention of quality healthcare providers is already a major challenge for our practices and many others, and this unprecedented move by BCBST will only make these challenges worse.  More healthcare providers may leave Memphis if this tactic is allowed to take place.

This action by BCBST will have a direct impact on our patients, families, and communities throughout the Mid-South. It will affect our hospitals, emergency rooms, and clinics. These facilities support some of our state’s most underserved communities. Delivery of care in rural areas will be particularly affected, as rate cuts of this magnitude mean that smaller care facilities may have to close their doors. Insurance companies come out ahead, while patients and health care providers bear the burden.

From a financial standpoint, BCBST showed a net income of over $520 million in 2021, a 46% increase over the previous year, and they are looking for ways to further increase their profits.  They are targeting physician groups and healthcare facilities that have been a part of the Memphis community for decades. They claim that this is to be more competitive and is in the best interest of patients, but this could ultimately result in narrowed networks, restricted access to care for patients, and healthcare provider turnover throughout the Memphis market.

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How and, more importantly, why is this happening? Insurance companies like BCBST are attempting to take advantage of a new federal law called the “No Surprises Act.” The intent of the law is to protect patients, but, unfortunately, some insurance companies are leveraging this law to force healthcare providers and facilities to accept drastic rate reductions or go out of network.

Our practices and providers are committed to protecting patients from reimbursement disputes. Even while these harmful actions by BCBST make it substantially more challenging for us to do our jobs and for patients to have access to quality care, we will never turn away a patient in need or sacrifice the level of care based on a patient’s ability to pay.

We encourage you to join us in this effort. Let BCBST know these cuts are not right. Let your employer know that if your insurance is through Blue Cross Blue Shield of Tennessee, they are putting money ahead of medicine, and there are better options. We know every voice can make a difference to help push back on this wrong.

Jordan Coffey, MD, is president of Medical Anesthesia Group. Hollis H. Halford III, MD, is president of Memphis Radiological P.C.

This article originally appeared on Memphis Commercial Appeal: Healthcare in Memphis: Changes could impact patients