JACKSONVILLE, Fla. — Florida Blue is up against the clock on reaching agreements not only with Baptist Health in Jacksonville but also with Naples Comprehensive Health in Southwest Florida as negotiations head toward a Sept. 30 deadline for keeping each of the health care systems in the Florida Blue network.
The outcome of the contentious talks will affect tens of thousands of residents, illustrating the wide impact Jacksonville-based Florida Blue has on health care as the state's biggest health insurance provider.
Florida Blue and Baptist Health, which have been in talks for months, have stepped up the pace of their negotiating sessions.
"Though we remain far apart in our respective proposals, we have made progress," Baptist Health said in a statement Thursday. "Our teams continue to negotiate and have committed to daily meetings through the end of the month when our current contract expires."
In Naples, NCH is telling patients on its website that "it is likely that Florida Blue will force NCH out of network."
When a health care provider falls out of an insurer's network, patients often face higher out-of-pocket costs if they wish to keep using that provider because the insurer stops covering any portion of the medical bill.
“Florida Blue just needs to pay us commensurate with what they’re paying everybody else,” NCH Healthcare CEO Phil Hiltz said in a Naples Daily News story about a community meeting NCH had Tuesday on the negotiations. “We want to get it resolved. But you know, you can’t negotiate with somebody who won’t negotiate.”
The negotiations in Jacksonville and Naples have parallels. The hospital systems say Florida Blue is reimbursing them substantially less than Florida Blue provides other providers for the same services.
Florida Blue says its reimbursements already are competitive and agreeing to the hospital system's proposals for reimbursement amounts would cause premiums to skyrocket.
"We are committed to keeping NCH in our network but cannot agree to their excessive demands for a 30% rate increase over several years because those increases are paid by our members and customers," Phil Lee, the west market president for Florida Blue, wrote in an open letter to the community.
Darnell Smith, the north Florida market president for Florida Blue, likewise says Florida Blue wants to keep Baptist Health in its network but cannot agree to the increase in reimbursement rates sought by Baptist.
"Our goal is to get Baptist Health to understand the Jacksonville community cannot and should not be asked to absorb the massive rate increase they are demanding, more than 60% over five years resulting in over $1 billion in additional payments going to Baptist Health and paid by the people of Northeast Florida," Smith wrote in a letter to the community.
Baptist Health has disputed Florida Blue's characterization of its proposals.
The negotiations are not done in public so it's not possible to say how far apart the two sides are. Florida Blue has put forward what it says Baptist Health's proposal would translate to in terms of percentage increases and cost, but Florida Blue has declined to quantify its own proposal in the same way for comparison.
In the Baptist Health and NCH negotiations, Florida Blue says the Kaiser Family Foundation pegs the medical inflation rate at 3.26%. Florida Blue says it is offering increases in reimbursements in amounts more than the inflation rate.
"Our proposal is fair, market competitive, and in excess of medical inflation," Smith said.
The negotiations with Baptist Health involve all Baptist hospitals in the Jacksonville area — Baptist Medical Center in downtown, Baptist Medical Center Beaches, Baptist Medical Center South and Wolfson Children's Hospital in Jacksonville — plus Baptist Medical Center Nassau in Nassau County. The talks also cover physicians who work for Baptist Health.
The NCH negotiations will determine whether its two hospitals, outpatient facilities and physicians group remain in the Florida Blue network.
This story was first published by Florida Times-Union.
