Blue Cross Shutout Impacts Northwest Health

Northwest Health System of Springdale remains locked out of the Arkansas Blue Cross Blue Shield network despite the best efforts of hospital and Springdale school officials to change the situation.

It appears unlikely that change is imminent – which may be costly to the hospital system and to state employees who opt to use Northwest.

Last fall, the hospital’s president, Russ D. Sword, tried to rouse support in hopes that public or legislative pressure would force Blue Cross to open its network.

The Springdale School Board, representing the state’s fifth-largest district, agreed. Its own employees were faced with a dilemma: economics versus choice of hospital and physician.

-Those state employees who opted for the least expensive medical insurance policy (that of Blue Cross, which charges just $33.78 a month for the employee only) pay only $10 for each doctor’s visit – so long as the doctor is part of the Blue Cross network – and face no deductible. The plan also covers all inpatient hospital expenses.

But if patients use Northwest or other out-of-network hospitals, Blue Cross pays only 70 percent of the bill. Also, no Springdale physician was included in the network.

rHospital administrators privately question how Blue Cross, which reported huge losses for last year, can offer such low rates. Competitors’ premiums, they note, are considerably higher. QualChoice, for example, offered a monthly premium of $81.08 for a similar plan.

Sword says he’s unable to say what the Blue Cross situation has cost Northwest to this point. Last fall, however, administrators estimated Blue Cross’ indemnity policy agreements were worth about $6 million annually to the hospital.

More than 300 Springdale School District employees chose the more costly plans that allowed them to use Northwest, Sword says.

One of those employees was Jim Rollins, the district”s superintendent.

?”I certainly did personally,” Rollins says about choosing the more expensive plan. But, he adds, “Our teachers are paying a significant penalty” in order to use the Northwest system.

Rollins is dismayed that the situation hasn’t been remedied.

“We have taken that issue to the governor”s office and spoken with a number of his key aides regarding this issue, and we have dealt with the Legislature and tried to convey our concerns about the current restrictions of [Arkansas] Blue Cross Blue Shield,” Rollins says. “At this point, I have not been given any encouragement to think there would be an immediate change, but I sure hope I’m wrong.”

Blue Cross partnership details

On another front, Blue Cross plans to announce on June 10 details of its partnership with St. Mary”s and Washington Regional Medical Center.

Melvin R. Blackwood, regional executive for Blue Cross, says the region includes nine counties in northwestern Arkansas.

The joint venture will offer a variety of products, including a health-maintenance organization and a point-of-service plan. It’s expected to be similar to other Blue Cross joint ventures with Sisters of Mercy, which owns, among other facilities, St. Mary’s in Rogers, St. Joseph”s in Hot Springs and St. Edward Mercy Medical Center in Fort Smith.

?Blue Cross has already named a medical director for the Northwest Region. He is Dr. Bruce Waldon, a general internal medicine physician who practices with Rogers Diagnostic Clinic.