Setting the Record Straight
I’d like to take the opportunity to set the record straight on Yavapai Regional Medical Center’s decision to leave the Blue Cross Blue Shield of Arizona network. Our hope is that Yavapai Regional Medical Center will choose to accept our proposal with a more than fair increase to the $124 million we already pay them for services on behalf of our members.
1. We would like Yavapai Regional Medical Center to stay in network.
After working for months to make this happen, we met them halfway, offering millions more, and they refused to meet us in the middle. The increased offer can be accepted at any moment, and we would welcome them with open arms.
2. Yavapai Regional Medical Center’s commitment to the community should extend to affordability.
According to published financial data, Yavapai Regional Medical Center has consistently posted positive operating profits. This is not a hospital in trouble financially and they have a strong record of managing their resources well on behalf of the community. Having said that, it’s not okay to give up on making healthcare more affordable. Across all the Blue Cross Blue Shield of Arizona networks, Yavapai Regional Medical Center is the fourth highest cost hospital in the state, receiving reimbursement rates that are twice the Phoenix hospital average, and three times the Tucson hospital average.
3. Yavapai Regional Medical Center receives $124 million from Blue Cross Blue Shield of Arizona each year.
We have had a decades-long productive relationship with Yavapai Regional Medical Center, with no disruptions. This positive relationship seems to have changed since becoming affiliated with Dignity Health. We would like Yavapai Regional Medical Center to accept the offer on the table so, on behalf of our members, we can pay them an increase on top of the $124 million they already receive annually.
4. Members will get the care that they need.
ER visits are always covered, and we have thousands of in-network providers in Yavapai County. According to Yavapai Regional Medical Center’s self-reported Health Information Exchange data, over the last 3 months there were an average of 3-4 people a day who would be out of network for inpatient stays. Our clinical teams are available 24/7 and working with providers to make certain patients get the care they need. Details on how inpatient members are cared for are found on azbluefacts.com/yavapai/your-care.
If a member requires admission from the ER, the inpatient stay may be handled in different ways, depending on the patient's medical circumstances:
- If a member needs more advanced care or treatment than the ER facility can provide, the patient would be transported to another facility that is able to provide the necessary care.
- If Yavapai Regional Medical Center can provide the care, and the patient can be safely transferred to an in-network facility, BCBSAZ will assess the situation and may arrange for the member's transfer at no added cost to the member.
- If Yavapai Regional Medical Center can provide the care, and the patient can't be safely transferred to an in-network facility, the patient will be covered in network at Yavapai Regional Medical Center.
5. We are concerned that Yavapai Regional Medical Center has cancelled patient appointments.
Yavapai Regional Medical Center appears to be causing patient disruption by cancelling patients who are either covered under continuity of care or are not part of the contract under negotiation. We have reports from patients that this has occurred and are working to ensure that those patients get care. When network transitions occur, the member’s health is absolutely the priority. Continuity of care is addressed by laws, contract language, and medical ethics to ensure that in-progress care is uninterrupted.
More details and live updates are available at azbluefacts.com/Yavapai. We will continue to work earnestly for our members. We look forward to moving together on behalf of health, community, and affordability.
Pam Kehaly, President and CEO, Blue Cross Blue Shield of Arizona