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Legacy And Regence Contract Deadline Expiring March 31, With No Deal In Sight Yet

Tens of thousands of patients face finding new in-network providers or paying out-of-network costs. Both remain in negotiations as of early Sunday evening.

PORTLAND, Ore. — The deadline for Legacy Health and Regence to come to terms on a new insurance reimbursement plan at the end of Sunday, and tens of thousands of patients face finding new in-network providers or paying out-of-network costs. 

Legacy provides healthcare for people in Oregon and southwest Washington, while Regence, a major health insurance company, covers 200,000 people who have Legacy primary care doctors. The two have been trying to come to terms to renew a payment agreement for most of the year, and in the final month before the contract deadline, Legacy did not accept a "best and final" offer from Regence.

"Regence continues to work with Legacy's leadership in hopes of finding a reasonable path to an agreement that will keep them in-network for our members while also supporting our commitment to affordable health care," said Regence, in part, in a statement on Friday. "We continue to negotiate in good faith in hopes we can keep Legacy providers and facilities in network for our members." 

Legacy also stated on their website Friday, "We are all facing a difficult situation as the contract negotiations between Legacy and Regence remain unresolved. Legacy is working hard to reach a fair agreement that will allow BlueCross BlueShield members to continue to receive quality care from Legacy providers. 

"However, we also have started preparing our patients for the possibility that the Regence contract will terminate on April 1. If this happens, many BlueCross BlueShield members will no longer have in-network access to all Legacy hospitals, clinics and services."

Both companies said they will help patients transition to other care, if needed.

The two are still 'actively' negotiating as of early Sunday evening, Regence said.

Legacy Health May Soon Be 'out Of Network' For Patients Insured By Regence

PORTLAND Ore. (KPTV) - Legacy Health patients who are insured by Regence Blue Cross Blue Shield may lose insurance coverage for that healthcare system starting Monday.

Regence Blue Cross Blue Shield customers could soon be considered 'out of network' at Legacy Health Systems. That means patients will either have to pay for their services out of pocket or find a different healthcare system.

Legacy Health vice president and chief population health officer Merrin Permut says this is all happening because Legacy's contract with Regence is set to expire at the end of the day Sunday.

"This is an incredibly heartbreaking situation," Permut said. "We're very concerned about what access there is, we already have very limited access within our community."

Without an agreement being met on a new contract just yet, that could mean thousands of Legacy patients will be uninsured.

"We have been doing everything we can to proactively reach out to patients that have upcoming appointments or procedures or surgeries, to make them aware of this, and to encourage them to explore what options they have available to them," Permut said.

Permut said they've tried to avoid this from happening with negotiations ongoing since November of last year. That was when Legacy informed Regence that there would be an increase in cost, she said.

"It's very common for us to have increases every year, that's really just accommodating the increases of life that we all see labor costs, supply, cost, inflation, all of those things," Permut said. "And really, for the past three years, our contract with Regence has had very small increases, because that was what we knew at the time. And now based off of our experience over the past couple of years, we need Regence to pay their fair share."

But this year, it was an increase Permut said Regence has refused to pay.

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In a statement, the insurance provider said they have offered reimbursement increases that meet many of Legacy's asks to get closer to an overall agreement only to have their leadership reject those proposals.

The statement goes on to say if an agreement is not met by the deadline, there are other options for Regence customers besides Legacy Health.

They said that by doing this, they are "holding the line on unreasonable provider reimbursement demands" because that's what their members have asked for.

As for how many people this will affect, Legacy said that within the last year, they've served 100,000 Regence patients.

"I am personally seeing every patient email and listening to some of the phone calls that we receive, and it is heartbreaking," Permut said. "We want to continue to serve our patients, we are trying to help them to the best of our ability navigate this situation. But it is very distressing for everyone involved."

If an agreement on a new contract is not met, those insured by Regence who continue to rely on Legacy will still have to pay their premiums, meaning they won't be getting the benefits they thought they signed up for.

In the meantime, nothing is set in stone just yet with negotiations expected to continue through this weekend.

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Portland-based Legacy Health And Regence Agree To New Contract; Legacy Salmon Creek Patients Stay In Network

Portland-based Legacy Health and Regence BlueCross BlueShield agreed to a new contract Sunday, allowing thousands of patients to continue accessing care through Legacy Health facilities using Regence benefits.

The two organizations announced the deal just hours before the current contract would have expired at midnight, according to a news release issued jointly by Legacy and Regence.

The organizations began contract negotiations in November 2023.

There will be no disruptions to care, according to a spokesperson for Legacy.  Patients can continue to see their Legacy doctors and use hospitals and services.

Patients who may have canceled appointments, due to uncertainty regarding the contract renewal, can contact Legacy to reschedule.

"We apologize for any stress or anxiety that these contract negotiations may have caused you," Legacy Vice President Merrin Permut said in the news release.  "We know how important it is for you to have continued access to your trusted health care providers and are grateful to bring you peace of mind with a resolution. We are so grateful to our patients and our communities for their patience and understanding while we worked with Regence on a new agreement."

Dean Johnson, strategic communications manager for Regence, shared similar sentiments with The Columbian.

"We are grateful that our members should have no further disruption in care, and we look forward to continuing our partnership with Legacy to ensure our members have access to an important care partner in our communities," Johnson said. "We recognize the uncertainty these negotiations caused for some Regence members and appreciate their patience as we worked with Legacy leadership to achieve reimbursement rates that are more sustainable for our members and customers."

Legacy announced Feb. 6 it could terminate its contract with the insurance provider if a deal could not be reached by March 31. Legacy stated Regence's payment schedule had not kept up with rising expenses in health care.

If an agreement had not been reached, Legacy would no longer be in-network for Regence members, which worried patients who receive care at Legacy Salmon Creek Medical Center.

Legacy said that during the pandemic, it received $171 million in federal funding from COVID-19 relief programs; however, that federal support went to offsetting lost revenue, increasing staffing and covering COVID-19-related supplies. According to Legacy, the health system saw a $172 million loss in its most recent fiscal year that ended March 2023.

Regence said Legacy asked for a double-digit rate increase in the new contract.

This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.Com/cfj.

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