Baptist Health Negotiates with Insurance Companies

Hundreds, if not thousands of people are finding out they may no longer be able to use Montgomery's largest health care system. Certain insurance companies are informing their customers that services performed at Baptist Health are no longer covered. It's all because of a contract dispute over the cost of care.

It's been known for some time that Baptist is experiencing financial troubles. The contract negotiations appear to be a way the company is trying to recoup some of its losses. WSFA has learned that Baptist is terminating contracts with insurance companies that don't agree to pay increased reimbursements. And that's leaving many policy holders in the dark.

Laura Birmingham works out of her home and uses her husband's health insurance company, HealthSpring of Alabama, Inc. The company sent her a letter informing her of the bad news. "I got the letter Saturday," said Birmingham. "And I was disgusted, to say the least."

The letter said that beginning next month, her policy would no longer cover services at any Baptist Health facility, meaning she could no longer see her own doctor. "He goes to Baptist South," she explained. "And they don't accept Baptist South any longer."

In the letter, HealthSpring claims Baptist initiated the change because it wanted to raise the rates it charges health insurance companies. But Baptist officials say there's still a chance all of this will be worked out.

In a statement released to WSFA, a spokesman for the hospital system said, "we are in the final stages of renegotiations with HealthSpring of Alabama. At this time we have no further comment."

Baptist is the only health system in Montgomery that offers neo-natal care and the only one with a full-service cardiovascular unit. So if HealthSpring's contract isn't renewed, its customers would have to travel to Birmingham or Mobile for those particular services.

HealthSpring customers like Laura Birmingham are holding out hope. "In the meantime, we'll hold our breath and make sure we don't get sick because if we do we'll have to pay for it," she said.

There are other insurance companies in the same boat as HealthSpring. United Health Care, for instance, has been told its contract with Baptist would be terminated this fall, unless it is renegotiated at a higher price.

However, the state's largest insurance provider, Blue Cross-Blue Shield, is not affected. WSFA is told Baptist did not attempt to charge them higher reimbursement costs even though Blue Cross-Blue Shield is Baptist's largest customer.

According to the Alabama Association of Health Plans, Baptist's tactics are typical in larger cities where there's more hospital competition, but they're new to Montgomery. Association president Mike O'Malley says he's hopeful Baptist and the insurance companies will come to an agreement.