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Why did Blue Cross kick HMA hospitals out of network?
Future of hospitals, patients, and doctors in jeopardy

by State Rep. John Moore
As a concerned member of the House of Representatives, I have a moral obligation to ensure that Mississippians have access to quality healthcare. Toward that end, I participated in a joint public hearing on September 16 to discuss Blue Cross Blue Shield’s business practices. Specifically, I wanted to know why Blue Cross had, without warning or explanation, terminated the contracts for 10 Health Management Associates (HMA) hospitals in the state. The result of this action by Blue Cross is that these 10 hospitals are now considered out-of-network providers for patients with Blue Cross health insurance. Simply put, this means Blue Cross members won’t receive full health insurance coverage at River Oaks Hospital, CMMC, Woman’s Hospital, Madison River Oaks Medical Center, Crossgates River Oaks Hospital, Biloxi Regional Medical Center, Natchez Community Hospital, Northwest Mississippi Regional Medical Center, Tri-Lakes Medical Center and Gilmore Regional Memorial Regional Medical Center.

At the hearing, I and other lawmakers learned that HMA is doing all they can to prevent patients from incurring additional out-of-pocket expenses. While Blue Cross has unilaterally decided to jeopardize healthcare access to thousands of Mississippians, HMA continues to find ways to control costs for their patients. But it’s clear that HMA can’t do this for much longer.

Doctors, physicians, and business officials testified at the legislative hearing. With each testimonial, the story was the same: strong-arm tactics by Blue Cross to control healthcare decisions; an unwillingness by Blue Cross to negotiate; and a strategic effort by Blue Cross to put profits before patients. Blue Cross’s decision to kick these ten hospitals out of network is harming Mississippians by reducing access to local, quality healthcare. People should be able to get local, affordable care when they need it – after all, that’s the purpose of health insurance.

It’s also likely that BlueCross’ actions will affect jobs throughout the state. BlueCross is the dominant health plan in Mississippi (with an 80 percent market share), and hospitals are often one of the top employers in their communities. If patients can’t go to HMA hospitals, then HMA will have no choice but to close these facilities – delivering a devastating blow to local economies.

HMA hospitals consistently rank among the highest quality facilities in Mississippi, and two out of every five babies born in Mississippi is born at an HMA hospital. The quality of healthcare provided at these hospitals is not in question.

I am currently identifying ways to remedy this solution, but Mississippians across this state need to voice your concerns. If you have already been impacted by Blue Cross’s decision to limit access to healthcare, the Legislature needs to hear from you. Contact your local legislator and tell them your story. For more information, you can go to http://www.keepmyhospital.org.

In the meantime, know that I will continue to work to find ways to put Health Management hospitals back in the Blue Cross network. Let’s all work together to ensure Mississippians across this state have access to quality healthcare.

Posted October 10, 2013 - 11:25 pm

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