Thousands of Portland-area patients are caught in the middle as Regence BlueCross BlueShield and Legacy Health hash out a contract showdown that could hit wallets as early as next month. If the two sides do not reach a new agreement, many Legacy-employed physicians, clinics and outpatient services could be treated as out-of-network for Regence members starting April 1, potentially driving up out-of-pocket costs. That prospect has people in ongoing treatment and employers who offer Regence plans worried about whether their care will be disrupted. Both organizations say they are still at the table, but they also say they remain far apart on payment rates.
In a news release, Regence said the current agreement with Legacy runs through March 31, and the insurer is trying to land a new deal before Legacy moves to out-of-network status. Regence says it is proactively contacting members who use Legacy and helping them identify other in-network options, pointing people to its online Find a Doctor tool. The company is framing its stance around affordability, arguing that large rate hikes would ripple into higher premiums and threaten the long-term stability of coverage for its members.
Roughly 29,000 Regence customers who rely on Legacy services have been warned that their coverage could change beginning April 1, according to OregonLive. The outlet reports that Regence says Legacy is asking for about a 22% rate increase over two years, a level the insurer calls unsustainable. Legacy, for its part, says it is seeking a reasonable boost to keep up with rising labor, supply and regulatory costs. OregonLive also notes that Legacy Silverton Medical Center and clinics in Silverton, Molalla, Keizer, Mount Angel and Woodburn operate under a separate contract and would not be affected by this dispute.
Recurring Negotiations Leave Patients On Edge
This is not the first time Regence and Legacy have taken talks to the brink. Previous negotiations between the two were settled at the last minute, creating a scramble for patients and employers with only a narrow window to adjust, as highlighted in an eleventh-hour deal saving Oregon patients. That pattern of brinkmanship has both sides aware of the potential for public blowback as the March 31 contract expiration draws closer.
Continuity Protections Are Limited
Some patients in active courses of care, including people in cancer treatment or pregnancy, may qualify for temporary continuity-of-care protections that let them stay with their Legacy providers for a limited period even if the contract lapses, according to Regence. Those protections generally require insurer approval and are time-limited. Members who need to line up in-network care can call Regence or use the Find a Doctor tool, and anyone with time-sensitive treatment is urged to ask about continuity options as soon as possible…