Decision by Blue Cross-Blue Shield impacts patients and employers throughout the state

PEORIA – OSF HealthCare is still part of Blue Cross and Blue Shield of Illinois PPO plans through December 31, 2017. At the beginning of this month, while still engaged in active negotiations, Blue Cross and Blue Shield of Illinois announced plans to drop three hospitals from its PPO network: OSF HealthCare Saint Francis Medical Center (Peoria); OSF HealthCare Saint Anthony Medical Center (Rockford); and OSF HealthCare St. Mary Medical Center (Galesburg). The termination was issued unilaterally by Blue Cross and Blue Shield of Illinois, and is set to occur January 1, 2018.

By removing these hospitals from its network, BCBSIL eliminates important referral centers and reduces patient access to advanced, critical services within our system. Without patient access to our terminated hospitals, OSF HealthCare was forced to terminate most of its remaining Blue Cross and Blue Shield hospital agreements. As of the first of the year, Illinoisans with BCBS PPO health insurance plans will only be able to access care at hospitals owned by OSF HealthCare using out-of-network benefits. The one exception will be OSF HealthCare Saint Anthony’s Health Center in Alton, which will remain in the BCBSIL PPO network.

“OSF HealthCare is an accountable care organization committed to population health, which is achieved through ensuring patients have access to the full resources of its integrated health care delivery system,” said Randy Billings, OSF HealthCare senior vice president of population health. “By eliminating three of our hospitals from its network, Blue Cross and Blue Shield eliminates important referral centers and patient access to nearby specialty care - including our children’s hospital.”

OSF HealthCare Children’s Hospital of Illinois was recently ranked in the top 50 by U.S. News & World Report for pediatric urology and neonatology. Blue Cross and Blue Shield has several quality programs recognizing hospitals and their performance to help members determine the best place for care, including Blue Distinction Specialty Care and Blue Distinction Total Care. OSF HealthCare hospitals are consistently high-performing in most of these programs. For a detailed listing, go to the Blue Cross and Blue Shield website.

Patients with Blue Cross and Blue Shield PPO plans living in rural communities served by OSF HealthCare hospitals will only be able to seek care in their own town, or access nearby tertiary and quaternary care in Peoria and Rockford, using out-of-network benefits.

“We are deeply disappointed and concerned by recent actions taken by Blue Cross and Blue Shield of Illinois,” said Billings. “It is our hope that Blue Cross and Blue Shield will realize the value of having OSF HealthCare hospitals in its network for its members. OSF is open to continuing discussions with Blue Cross and Blue Shield to avoid a disruption to patients.”

BCBSIL members can contact their employer regarding other insurance company choices or may direct concerns or benefit plan inquiries to the Blue Cross and Blue Shield Customer Service phone number at (800) 538-8833.

In the meantime, OSF HealthCare encourages employers and community members who rely on us for their health care needs to choose an insurance product that ensures access to the full breadth of services that OSF HealthCare provides. OSF HealthCare participates in most national and local managed care plans. A complete list can be found at osfhealthcare.org.

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