Jan. 4, 2024, 4 p.m.
5 Things to Know About Contract Negotiations
Providence’s first focus is our patients. We know you rely on Providence to keep you and your family healthy. Every day we are hard at work to make care more accessible and affordable for everyone we serve.
Yet, we face serious challenges. Health systems across the country and in our community, including Providence, are experiencing the crushing weight of rapidly rising costs of care caused by inflation, labor shortages, wage increases and supply disruption.
To continue as a reliable source for quality, convenient health care and pay our doctors, nurses and caregivers for the services they provide, we need sustainable reimbursement from Regence, one of the state’s largest health insurance companies. Other health insurers understand these concerns and have signed agreements with Providence for 2024, partnering with us to provide services and keep access to care available.
Here are five things to know about contract negotiations in Oregon between Providence and Regence.
What is happening between Providence and Regence?
For months, Providence has been negotiating with Regence for fair and sustainable reimbursement rates to pay our doctors, nurses and caregivers for the services they provide to our patients with Regence insurance.
Unfortunately, Regence has been unwilling to accept the reimbursement rates we last proposed on Nov. 8, 2023, and has refused to provide a counterproposal with any alternative solutions since that time. Providence, meanwhile, has made several additional attempts to come to agreement before the contract termination deadline.
Regence’s failure to compromise means that more than 260,000 Oregonians may be out of network at Providence hospitals and clinics after our commercial contract expires on Jan. 15, 2024, and our Medicare Advantage contract expires on Feb. 15, 2024.
What is the difference between in network and out of network?
“In network” means Providence has an existing contract with Regence to see patients and get paid for the services we provide at a contracted rate. “Out of network” means Providence does not have a contract with Regence, and you may pay a different amount based on the health insurance plan you have with Regence.
What if I have an appointment or procedure scheduled at Providence?
Patients should contact Regence directly at 1-888-675-6570 with questions about how their insurance coverage may be affected if our contract expires.
If an agreement isn’t reached, Providence may be out of network for Regence members, and you may pay a different amount based on the health insurance plan you have with Regence.
Can I still use Providence for emergencies?
Yes. By law, patients always have access to our emergency departments, regardless of our contract status with Regence. If you experience an emergency, you should visit the nearest emergency department.
What can I do?
We still hope to reach an agreement that benefits everyone. In addition to exploring other health insurance plans that contract with us, you can take these steps to protect your access to in-network care with Providence:
- Call Regence. Use the number on the back of your insurance card or call 1-888-675-6570 and tell them how important it is to have in-network access to Providence hospitals and clinics.
- Contact your broker. If you have a Medicare Advantage or Individual plan through a broker, ask about coverage options that will protect your in-network access to Providence.
- Talk to your HR or benefits manager at work. If you receive your health insurance through your employer, ask your Human Resources or benefits manager about other options that will protect your in-network access to Providence.
- Apply for Continuity of Care. Patients who are pregnant or getting active treatment for a chronic condition may qualify for extended in-network access through Regence. If you think you may qualify, call the number on the back of your insurance card.
We understand that disruptions in your access to health care are frustrating and will do our best to keep you updated. As always, Providence has a team of financial counselors available to help those who are uninsured, underinsured or otherwise unable to pay for their health care, providing assistance with medical bills, including free or discounted care. Patients can learn more our our financial assistance website.
Thank you for trusting Providence with your health care needs.
Related: Providence Urges Regence: Take Action Now to Ensure Oregonians Maintain Access to Health Care
