Regence BlueCross BlueShield Sets Off Fury Among Members

The latest move by Regence officials will require people to pay more money to see their physician of choice
The Lund Report

May 2, 2012 -- When Regence BlueCross BlueShield of Oregon decided to slash the medical benefits for people in the Portland metropolitan area, its management team could never have imagined the fury that it set off.

“It represents a total destruction of having a choice of providers; the only reason I chose Regence was because of its large PPO network,” said one disgruntled member. “I feel squeezed out.”

That woman spoke to The Lund Report on the condition that we wouldn’t disclose her identity for fear of repercussions from Regence.

She was reacting to a decision that impacts 20,000 Regence members starting October 1 when their current PPO network of physicians and hospitals comes to an end.

Unless people are willing to pay more out-of-pocket costs to see their physician of choice, they’ll be transitioned to the provider networks at Tuality Healthcare or Adventist healthcare systems.

“We recognize that your relationship with your doctor is personal, and you can continue to see your current provider,” Penny Garrett, director of customer service at Regence, told policyholders in a letter dated April 24. “However, all visit to out-of-network providers occurring after your upcoming renewal date will be subject to higher cost sharing.”

After people began receiving those letters, the phone lines at insurance agent offices were flooded with calls from angry people, many of them extremely upset. “People are particularly unhappy about losing their own physician and are calling us and sending emails,” said Richard Skayhan, an agent who works for Leonard Adams Insurance. “We’re sending them over to ODS because their rates and design coverage are
the best in the area.”

“Regence’s real goal is to get people off their health plan, particularly those who see specialists and demand too many imaging tests such as MRIs,” said a high-level source inside the company who contacted The Lund Report yesterday. “Cutting down the number of individuals on our health plan is management’s goal.”

Linda Roach, who’s been insured by Regence for many years, believes the insurer is padding its bottom line at the expense of ratepayers such as herself.

“I'm frustrated, I'm angry, and I'm afraid of what the future holds,” said Roach, a Portland-based medical and science reporter. “Even if I can afford to keep paying the monthly premiums after October, Regence is dumping so many additional costs of care onto me that I don't know how I'll ever be able to afford to use this underinsurance at all.

“Oregon's history of healthcare cost containment blessed us with some of the lowest insurance premiums in the country until a few years ago,” she added. “As a state we were proud of this accomplishment. Self-employed people like me were able to afford to buy medical insurance, and the companies were fairly compensated. Now Regence is jumping through this loophole in the Patient Protection Act without regard to the consequences it will have for Oregonians”

Regence officials refused to respond to questions from The Lund Report about their recent decision to make these benefit changes, and, instead, sent a press release which said, in part:

“Providing affordable coverage is one of our top priorities at Regence. Both the Adventist and Tuality health systems are collaborating with us to deliver quality care at an affordable price,” said Don Antonucci, president of Regence BlueCross BlueShield of Oregon. “We know the doctor-patient relationship is personal, and this may mean a change for many of our members. We are confident, however, that they will continue to receive top-level care, and we will do everything we can to make this transition as smooth as possible.”

Regence is also eliminating one of its individual health plans known as Oregon Evolve Plus. Its 30,000 members will have to pay a $2,500 deductible for medical services and

$3,500 for prescription medications before Regence covers any of the cost starting on October 1.

By raising these deductibles, Regence can no longer participate in the Family Health Insurance Assistance Program, according to Tom Jovick, administrator. That program pays the monthly insurance premiums for uninsured children and families.

Regence officials also intend to submit a rate request later this month, according to Cheryl Martinis, spokesperson for the Oregon Insurance Division, and has not indicated whether it will request a decrease or increase in the premium rates for all of its 57,000 individual policyholders.

Last April, Regence requested a 22.1 rate increase, which was trimmed to 12.8 percent by the Insurance Division.

Inevitably Regence’s decision could price people out of the individual market, said Jason McNichol, interim executive director of the Oregon Health Action Campaign and executive director of Health Advocacy Solutions.

“The only people willing to pay these escalating premiums are going to be the high risk; those most likely to have higher utilization,” he said. “If you strangle the individual market, it will even get more unaffordable because healthy people are less likely to pay these exorbitant premiums. Only the sicker will stick it out.”

To read a commentary about Regence's decision by Linda Roach, click
here.

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