UC Health, Blue Shield extend contract deadline, stave off disruption of care
This means the thousands of Californians who get medical care at UC Health through Blue Shield of California — including many in the Bay Area who go to UCSF and One Medical, a UCSF affiliate — have an additional 30 days of breathing room before potentially having to find a different health insurer or pay out-of-network rates for services if UC Health and Blue Shield cannot reach a new contract.
UC Health and Blue Shield have been renegotiating contracts to establish how much Blue Shield will reimburse services provided by UC Health hospitals, clinics and other facilities. One Medical is an affiliate of UCSF Health, one of the six UC Health academic medical centers statewide.
Contract negotiations between health care providers and insurers are routine and often involve disagreements over reimbursement rates. In recent years, the tenor of such negotiations has grown more public and combative, often with each side accusing the other of taking positions that would ultimately harm consumers through higher prices or less accessible medical care.
Late last week, San Francisco City Attorney David Chiu and Supervisor Matt Dorsey waded into the matter, urging Blue Shield to finalize an agreement with UC Health so that the roughly 5,000 city employees and retirees who go to UCSF for medical care will not lose access to critical medical services.
Last year, UC Health and Anthem Blue Cross, another major insurer in California, similarly had a dispute over contract terms that lasted months. The two sides eventually reached a new contract.
In the Bay Area, the outcome of the negotiations between UC and Blue Shield could impact residents insured by Blue Shield who get care at UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland. It includes people in CalPERS plans, employer plans, Covered California plans and Medicare plans (including Medicare Advantage) offered or administered by Blue Shield.
The negotiations do not affect UCSF Health Community Hospitals at Saint Francis and St. Mary's, which will remain in-network.
Both UC Health and Blue Shield said Monday that they hope to reach a new agreement and avoid interruptions for their patients and members.
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