Johns Hopkins will go out of network with CareFirst BlueCross BlueShield on Dec. 5 if the two sides are unable to reach a new contract, The Baltimore Sun reported Sept. 8.
Johns Hopkins Health System President Kevin Sowers told the Sun that the cost of providing care rose 21 percent over the past decade, but CareFirst's rate increase was only 10 percent. He said CareFirst was paying less than other insurers.
CareFirst, Maryland's largest insurer, told the Sun that Johns Hopkins is requesting rate increases higher than the rate of inflation. The company also said it may be unfair to compare it to other large payers that are for-profit, out-of-state companies that can "pick and choose the communities they serve."
The health system and CareFirst have not been able to reach an agreement over the portion of patient bills that go toward physicians, other providers and potentially other fees, according to the report. Rates for direct hospital services are set by the state under an agreement Maryland has with the federal government. Hospitals officials in Maryland do not negotiate those rates, and all insurers pay the same rate.