JSD 117 One of Many Employers Switching Health Insurance Providers Amid Springfield Clinic-Blue Cross/Blue Shield Dispute

By Benjamin Cox on November 15, 2021 at 8:40am

One Jacksonville employer has already made a switch in health insurance providers amid an ongoing battle with Springfield Clinic and Blue Cross Blue Shield of Illinois.

Beginning on Wednesday, services from Springfield Clinic’s doctors, nurse practitioners, physician assistants, and other professionals will be considered out-of-network for patients insured through Blue Cross and Blue Shield preferred-provider plans.

It doesn’t appear that the dispute over what’s been characterized as “market-competitive rates and fair business terms” for patients in rural communities will be resolved between the two entities will be resolved any time soon. Springfield Clinic, in written communications with patients, has criticized the “record profits” earned by Blue Cross’ parent company during the COVID-19 pandemic while failing to provide information on its own revenues. Blue Cross has responded in kind, noting that health care costs in Springfield are 16% more expensive than the City of Chicago. Calling Springfield Clinic’s “artificial, above-market reimbursement rates in the middle of a global pandemic” an intentional mark up in health care costs and “not sustainable” for its members.

Jacksonville School District 117 is one of the entities that has gotten out ahead of the problem. Superintendent Steve Ptacek says that the district’s employees voted ahead of their insurance contract that ended on October 1st and decided to go with a different carrier: “This is not about cost savings at all. This is about ensuring that our staff is going to be able to maintain the services of Springfield Clinic as in-network. My Human Resources Director Tammy Stice was really on top of this early and let us know that there was a very strong possibility we were going to lose Springfield Clinic as our in-network provider. We immediately went out and got bids from all competitive companies. We got four bids – one was obviously our new provider United Healthcare and one was Blue Cross-Blue Shield, and there were two others. All four bids were cheaper than last year. It turns out that during the Covid year, we didn’t spend as much as we had in the past, so all of the bids would have been a savings to the taxpayers. Each of the bids were very close to each other. What it came down to was services, so we had meetings in early August with our staff to go over all the different options. Then, we allowed our staff the opportunity to vote and that made the determination which company we were going to go with.”

Ptacek says the transition to United Healthcare has been smooth and he believes employees of the district have been appreciative of the fact that Springfield Clinic will remain an in-network provider for the near future.

According to the State Journal Register, Athens School District made a similar jump ahead of their own October 1st deadline. Memorial Health and SIU School of Medicine have reported that both have had thousands of requests for switch in primary care and specialists over the last 60 days while the disagreement continues between the two entities.

Springfield Clinic estimated more than 100,000 people, or about 20% of the clinic’s patients, could be affected by the ongoing dispute.