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News / Business / Clark County Business

Patients could face out-of-network costs if Legacy Health, Regence negotiations fail

Clark County patients worry about changing doctors, having to wait for care

By Chrissy Booker, Columbian staff writer
Published: March 8, 2024, 6:02am

As contract negotiations continue between Portland-based Legacy Health and Regence BlueCross BlueShield, patients at Legacy Salmon Creek Medical Center are worried what a potential contract termination would mean for their access to care.

“I felt my heart sink, honestly, when I heard the news,” said Battle Ground’s Karmen Presley, a Legacy patient who’s pregnant with her second child. “Just the thought of having to find a new doctor, which is really important around a sensitive thing like a pregnancy. You want to have confidence in your provider. The thought of searching for a new one was kind of daunting for me.”

Legacy announced Feb. 6 it might terminate its contract with the insurance provider March 31, stating Regence has not kept up with the rising expenses in health care. If an agreement is not reached by that date, Legacy would no longer be in-network for Regence members, except for emergency care. As a result, patients may have to pay more out of pocket for services at Legacy.

In a Feb. 6 statement from Regence, the insurance provider said it was disappointed that Legacy went public with the discussions early, alarming members.

Presley said Legacy Salmon Creek is the closest hospital to her. If the hospital becomes out of network, she said, she would have to travel 32 minutes to PeaceHealth Southwest Medical Center in Vancouver.

“A concern I have is the surge of displaced BlueCross BlueShield patients competing for in-network providers with this change, and what the capacity will look like at PeaceHealth’s labor and delivery ward when the time comes for us to deliver our child,” Presley said.

Felida resident Marley Thompson also receives care at Legacy Salmon Creek. She said she is four months pregnant and was recently diagnosed with gestational diabetes, making her pregnancy high risk. If the hospital becomes out of network, she would lose access to the doctors who are familiar with her case, she said.

“It’s kind of the last thing you want to deal with when you’re pregnant. The last thing I’m supposed to do is stress, but I feel like that’s all I can do until I at least know,” Thompson said. “I feel like the only people that get hurt in this are the patients.”

Presley said she worries about patients who live in rural areas if Legacy Salmon Creek Medical Center was no longer an option.

In a March 1 update from Regence, the insurance provider said, “we are acutely aware that these negotiations have real impacts on people’s lives. Our customer service team is ready to help members navigate to alternative care if Legacy chooses to leave our network on March 31.”

Days later, Legacy sent out an update in a community letter from Vice President Merrin Permut, stating “as our negotiations continue with Regence BlueCross BlueShield on a new contract, it is important for us to correct misinformation you may be hearing.”

Legacy said that during the pandemic, it received $171 million in federal funding from COVID-19 relief programs; however, that federal support went to offsetting lost revenue, increasing staffing and covering COVID-19-related supplies. According to Legacy, the health system saw a $172 million loss in its most recent fiscal year that ended March 2023.

“While hospitals have been forced to deplete their savings to cover their losses, Regence has used its profits to continually build up financial reserves,” Permut said in the community letter.

Regence said Legacy asked for a double-digit rate increase in the new contract.

“Our priority is to come to an agreement on a contract that balances the need to increase compensation for doctors and nurses, while holding the line on the cost of care for our members and employer group customers,” Regence said.

For more information on contract negotiations, patients can visit the Legacy Health frequently asked questions page at www.legacyhealth.org or the Regence newsroom, www.regence.com/home.

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This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.