OU Health Physicians, BlueCross BlueShield face contract deadline, jeopardizing OU employees’ in-network coverage | News

Bizar Male

With a contract agreement deadline with BlueCross BlueShield less than two weeks away, OU Physicians held a virtual town hall Friday afternoon to address a conflict that can affect the future of health care for OU employees.

If an agreement is not reached between OU Health Physicians and BCBS by Feb. 28, OU employees utilizing benefits from OU Health Physicians will enter a 120-day transition period before being considered out-of-network for medical insurance. The negotiations affect four OU Health centers: University of Oklahoma Medical Center, Stephenson Cancer Center, Edmond Medical Center and Oklahoma Children’s Hospital.

Executive Dean of the OU College of Medicine John P. Zubialde and Senior Vice President and Provost of the University of Oklahoma Health Sciences Center Jason Sanders gave a presentation of the situation and answered questions from concerned OU faculty.

“The bottom line is that when we don’t have the resources that we need to be able to do what we do, we’re not going to be investing in our academic research and clinical care missions,” Zubialde said. “BlueCross BlueShield undervaluing us in these contracts does exactly that.”

Zubialde said OU Physicians asked for more funding because the non-profit feels it’s being undervalued, and that BCBS saw the request as a “greedy” attempt by OU Physicians to increase the cost of healthcare for patients. 

“The implication to that, I think, is that we’re basically greedy doctors wanting to try and basically drive up the cost of care for Oklahomans,” Zubialde said. “We are asking only for parity in our contract and the rates that we receive from other major commercial insurers.

In a slide presentation, Zubialde and Sanders said one reason OU Physicians asked for more funds in the contract negotiation was because it noticed a significant increase in BCBS windfall profits during the pandemic. Zubiade said, based on his knowledge, BCBS is using these profits for out-of-state purposes, rather than using the additional gains on the OU community.

“The most interesting information that we have recently gotten shows that (BCBS’s) margins have actually reached an all-time windfall high during the pandemic,” Zubialde said. “So really, this is about achieving parity in our contracts with other commercial providers, not so that we can raise the salaries of doctors, but to be able to help us gain, to recruit and retain the kind of talent that we need for the state.”

In an OU Faculty Senate meeting held Feb. 8, members and guest speakers voiced their concerns over the contract battle. OU Law Professor and guest speaker Mary Sue Backus said although OU Physicians isn’t doing anything unusual trying to get more funds, there was a lack of transparency in the process from the university. OU faculty and staff received notice of the contract dispute recently, while Zubialde said Friday negotiations have been going on for “over a year.”

“What I object to is the lack of transparency, a lack of consideration for the sort of the anxiety and trauma that one might go through,” Backus said. “For instance, if you thought you might be losing your oncologist, or some of your other own physicians. I just think that it is just really shitty for them to use faculty and staff as a negotiating leverage tool.”

Zubialde and Sanders said OU faculty and staff should reach out to BCBS and ask how their insurance plans will be affected should they enter the 120-day transition period if negotiations don’t end by the deadline.

“We’ve been here much longer over … BlueCross BlueShield,” Sanders said. “Insurers will come and go, your health physicians will not come and go. They will be here just as they have been. This is a life calling for healthcare professionals. … Unfortunately, insurance companies can make artificial deadlines. Someone comes to our emergency room right now, someone needs to come to an urgent care clinic, someone needs a prescription — We live in the now.”

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