Brittney Lofthouse – Staff Writer

It has been just over a month since Mission Health System and Blue Cross Blue Shield North Carolina were unable to come to an agreement to extend their contract. As of Oct. 5, those seeking care at Mission Health Systems Hospital who are ensured by Blue Cross Blue Shield are faced with paying higher cost for services as the hospital and affiliated doctors and practices are considered “out of network” for the insurance provider.

Despite the fact that Mission Health has been very vocal for months regarding the lack of communication from BCBS and was very vocal and quick to announce the contract’s anticipated ending months before it ever happened, the hospital system has refused to provide the public or the media with any information regarding the current status of negotiations. Last week, the hospital said they had no further comment on the matter.

“Mission Health has always been and will always be interested in any deal with Blue Cross and Blue Shield of North Carolina that enables us to effectively meet the important healthcare needs of the citizens of Western North Carolina,” said Rowena Buffett Timms, Senior Vice President, Government and community Relations for Mission Health. “We don’t have any further comment on any negotiations.”

Blue Cross and Blue Shield North Carolina confirmed Tuesday afternoon that negotiations are ongoing.

“Blue Cross and Blue Shield of North Carolina and Mission Health have entered into discussions regarding a future network participation agreement, and will refrain from public comment until those talks are completed,” said BCBS.

When asked about BCBS’ confirmation and to get a statement from Mission, Mission said, “We have previously said that we were not going to comment, and we continue to refrain from comment.”

While the hospital giant did not have any comment regarding negotiations, Timms did note that in the month since the contract has ended, Mission health has helped 3,009 patients apply for BCBS Continuity of Care programs, which allows some patients to continue receiving care for health issues through Mission and still be considered “in-network” as well as aided 47 patients with requests to access specialty services at Mission Health through the Reasonable Access statute.

BCBS insures 260,000 people living within the service area Mission Health System operates. While 260,000 people are insured by BCBS, it is unknown how many of those people also utilize Mission Health Systems. To know how many people are impacted by the contract ending, one would need to know how many BCBS patients use Mission Health Services.

In a private email obtained by Asheville Citizen-Times, Mission Health CEO Dr. Ron Paulus addressed about 60 senior employees and wrote, “When leaders from across North Carolina and beyond called to ‘warn me about what Blue Cross would do,’ I listened carefully but was skeptical.” The approximately 600-word private email accused BCBS of lying to its clients. Dr. Paulus wrote, “I didn’t think that was possible from a multibillion dollar company, but alas it was and it is.”

Dr. Paulus later said that the email was not for the public or for BCBS to see. BCBS requested that Dr. Paulus retract the statements in the email, which they claim to be “defamatory and inflammatory” and said that the message makes negotiations between the two entities more difficult.

Connie Scott, a Macon County employee who is insured by Blue Cross and Blue Shield posted on the Macon County News Facebook to share her story about how she has been impacted since the contract ended.

“I had a recent diagnosis of cancer,” write Scott. “I have appointments today at Duke Center Hospital and then UNC Cancer Hospital for treatment options. I am thankful for my BCBS insurance as a Macon County employee.”

Debby Dillon noted that she is forced to drive to Sylva for a simple test, because several of the doctors located in Franklin are under the Mission Health umbrella and no longer take BCBS.

Mission Health doctors who no longer take BCBS is not the only blow Franklin residents continue to grapple with in terms of local health care. Since ending labor and delivery at Angel Medical Center earlier this year, Mission Health has also decreased the number of providers in Franklin and have transitioned doctors and downsized practices. A half dozen of doctors have been named by local residents as no longer being available because of Mission Health.

“I lost Dr. Gaddy-Dubac, Judy Leighton, and Cindy Noland from Mission Women’s of Franklin,” said Emily Woods Wilson. “I love Dr. Elizabeth England, she delivered my baby this year before L&D shut down and stayed with the practice after it was gone, but now she’s out of network because Mission no longer accepts Blue Cross insurance.”

Some Franklin residents said their doctor had to relocate because Mission was going to triple their monthly office rent and gave the practice, as well as patients, only a 30-day notice of the change.

Additional doctors no longer serving patients include Dr. Jason Creel, Dr. Luella Guzman, Dr. Hunley, Tina Coffey, PA, and Dr. Carole Peterson. Other women and children’s providers named to no longer be serving the area include Anne Karner, and Dr. Wang.

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