Insurance controversy continues

Thursday, September 18, 2014

Treatment of an Ebola patient in an Omaha hospital reinforces Nebraska's reputation as a state with good medical care, but a dispute between a major health insurance company and one of its largest medical networks stands to undermine that status.

An Aug. 31 deadline passed without an agreement between Blue Cross Blue Shield of Nebraska and CHI Health -- Catholic Health Initiatives, which includes hospitals in Omaha, Schuyler and Plainview, as well as Lincoln, Grand Island, Kearney and Nebraska City.

Kearney's Good Samaritan Hospital is of special concern for Southwest Nebraska, since it's designated as a trauma center for the region.

The impasse left some 1,400 doctors "out of network," meaning Blue Cross Blue Shield would pay a smaller proportion of a patient's bill, but about 530 of them have changed affiliation to remain in network.

Blue Cross says CHI Health, formerly Alegent Creighton Health, routinely charges 10 to 30 percent more than other Omaha hospitals. CHI Health says those figures are misleading and its total cost of treatment is lower, even if certain services cost more.

Since hospitals must cover costs from patients who are unable to pay by shifting them to patients and insurance companies that can, it's not surprising that those serving economically disadvantaged communities charge more for services.

It's also not surprising that just such a conflict would arise in Nebraska, which has chosen not to expand its Medicaid coverage under Obamacare.

It's only likely that Blue Cross Blue Shield and CHI Health will reach an agreement sooner or later, but it's almost certain that neither side will be happy, and we'll all pay.

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