Baptist Health and Florida Blue are Northeast Florida's largest health care system and health insurance provider. The two have served Jacksonville for a combined 149 years. | Florida Blue; Baptist Health
Published on September 15, 2024 at 8:30 pm
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With two weeks left before their current contract expires, Jacksonville’s largest health care system and largest Jacksonville-based insurance company appear no closer to reaching an agreement to keep patients in network.
Florida Blue and Baptist Health’s current contract ends Sept. 30. If negotiations are not successful, as many as 50,000 Florida Blue members in the region would then have to pay out-of-network costs for most but not all services at Baptist Health and its Wolfson Children’s Hospital.
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The latest disagreement hinges on reimbursement for services at Wolfson Children’s. Baptist and Florida Blue blame each other for the impasse.
Baptist alleges Florida Blue pays other health systems more than what it's proposing to pay Baptist.
“We will not put people in a situation where they don’t know what they owe out of pocket or receive surprise bills, because we simply do not have confidence that Florida Blue will treat us fairly or pay accurately. Out-of-network is not a solution for our patients or Baptist Health and Wolfson Children’s, even if that’s what Florida Blue seems to want at this point," Baptist said in a statement Friday.
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Baptist pledged to provide emergency, necessary and continuity of care for all patients at Wolfson.
Florida Blue says it is offering a higher rate of payment for services at the region’s only children’s hospital, a change from previous agreements. Florida Blue also pledged to cover insurance claims at Wolfson Children’s Hospital through October, whether or not an agreement has been reached.
“It is Florida Blue’s responsibility to protect our members from out-of-control and unnecessary cost increases, which they cannot afford,” Florida Blue North Florida Market President Darnell Smith said in a Friday statement. “Baptist Health’s latest demands remain outrageous and unacceptable. Their proposed rate increase — over $1 billion in additional reimbursements — would unfairly burden our members and this community.”
Smith has taken a more active role in the negotiations as the deadline approaches at the same time he wraps up a nine-month stint as chief of staff for Jacksonville Mayor Donna Deegan, serving as an executive on loan while Florida Blue paid his salary. On Friday, Deegan announced Mike Weinstein will take over as chief of staff, as Smith could transition full-time into negotiations with Baptist next week. Weinstein has served as chief negotiator for the city in its stadium renovation deal with the Jacksonville Jaguars, but City Council cut funding for Weinstein’s negotiator position as it finalizes the new year's budget.
A Kaiser Family Foundation analysis found medical costs increased at a rate higher than inflation in June for the first time since 2021. And PricewaterhouseCoopers’ Health Research Institute projected medical costs will grow 8% to their highest level in 13 years in 2025.
Baptist Health Chief Medical Officer Dr. Timothy Groover told Jacksonville Today in August that investments the hospital has made in recent years require a stable funding source.
In its Sept. 13 statement, Baptist said it is asking for a reimbursement that “is significantly less than what every other health plan pays us.”
Editor’s disclosure: Florida Blue and Baptist Health are both financial supporters of WJCT Public Media, the parent company of Jacksonville Today.
