Johns Hopkins to go out of network with CareFirst on Dec. 5 without new contract

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. 

Advertisement

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. 

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

Advertisement

Next Up in Contracting

Advertisement

Comments are closed.