YRMC & BCBSAZ Reach New Agreement as UnitedHealthcare & Phoenix Children’s Continue Negotiations

After months of tough negotiations, a new agreement between Blue Cross Blue Shield of Arizona (BCBSAZ) and Dignity Health’s Yavapai Regional Medical Center is now in effect as Phoenix Children’s announced its conducting contract negotiations with UnitedHealthcare (UHC).

Increasingly difficult negotiations are now happening between providers and payers as contracts rates term and the industry recovers from the COVID-19 public health emergency.

In February 2023, contract negotiations between the largest hospital in Yavapai County and Blue Cross Blue Shield of Arizona (BCBSAZ) failed impacting an estimated 11,000 patients in rural Arizona.

On April 28, Yavapai Regional Medical Center confirmed the new three-year, in-network agreement with BCBSAZ will assure medical care for those with private insurance and employee-sponsored insurance. In-network coverage is retroactively effective April 1, 2023.

President and CEO of Dignity Health YRMC Anthony Torres, MD,

After many months of negotiations, we are very pleased that Blue Cross Blue Shield of Arizona has agreed to a new contract that will put our patients first and keep health care local. Providing local high-quality healthcare services is a top priority and we look forward to furthering our mission of improving the health of those who call Yavapai County home.

BCBSAZ Chief Medical Officer Cara Christ, MD,

Standing up for our members has always been our priority, and we are thankful that Yavapai Regional Medical Center joined us in this effort. Together, we can ensure those in Yavapai County have access to the care they need while protecting affordability.

Meanwhile in Maricopa County, if Phoenix Children’s and UHC can’t reach an agreement by May 31, 2023 the hospital will no longer be an in-network provider for patients insured under UHC employer-sponsored and commercial plans. The insurer’s Medicaid product, UnitedHealthcare Community Plan, is not impacted by these negotiations nor is emergency care necessary regardless of a patient’s network status with UHC.

Phoenix Children’s President & CEO Robert L. Meyer addressed the public in a press release,

Please know we will continue to work with UnitedHealthcare over the coming weeks to reach an agreement and hopefully avoid any disruption to the exceptional care you’ve come to expect from Phoenix Children’s.

In a statement to The Hertel Report, UHC said it it has made multiple compromises throughout its negotiation with Phoenix Children’s including market-competitive rate increases.

We remain fully committed to good-faith negotiation and urge Phoenix Children’s to work with us to reach an agreement that is affordable for families and customers in Arizona.

According to reporting from Modern Healthcare, as providers try to set multiyear contracts that account for providers’ higher-than-average labor and supply costs, looming Medicare reimbursement cuts and other financial pressures, expect tougher than usual contract negotiations in 2023. So far, 27 contract disputes between providers and payers have been reported this year, up from 11 last year.