NCH Healthcare System, an in-network provider for Florida Blue for many years, may be considered out of network at the end of September if the two parties can’t come to an agreement.
NCH maintains that it can’t provide its services at the current level of Florida Blue’s reimbursement, and Florida Blue believes NCH is asking for an unreasonable payment rate.
The hospital held a town hall-style meeting this week, where NCH President and CEO Paul Hiltz described the problem, and what he hopes will happen.
“We hope, and we think this can be resolved, before the end of this month, if they just come to a fair rate,” said Hiltz.
Dr. Betsy Brothers is OB/GYN Department Chair at the hospital.
“We had a record number of deliveries in August, the highest number since pre-Covid. And with the commitment of the hospital to taking care of women and children, despite the poor compensation, we have to certainly acknowledge our community’s hospital as being a good steward for all the women and children here in Naples and in Collier County,” Dr. Brothers said.
Chief Operations Officer Jon Kling says in his 22 years at NCH, the health system has never been this close to going out of network with an insurance provider. He says that their costs have risen, and reimbursement has not kept up.
“The pandemic, and the current inflationary impacts in our community, in our nation, have exacerbated this, to the point where we can no longer provide the services and continue to lose the dollars we are for the services we provide,” said Kling.
Phillip Lee is Florida Blue’s Market President for the West Region, which includes Southwest Florida. He says that there are about 40,000 Florida Blue members in the Naples community. He adds that what the hospital is asking for is not tenable.
“NCH has continued to request rate increases and demands that are absolutely unreasonable,” said Lee.
Yet he, like the NCH staffers, claims to be looking out for NCH patients.
“We’re committed to working with NCH to arrive at and provide some level of resolution. But we are really advocating on behalf of the people we are here to serve.”
The current contract expires on September 30, at which point, if there is no new contract, NCH Health System will be out of network for Florida Blue members.
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