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Special notice for patients with Empire BlueCross
Thursday, February 9, 2023
The information provided below has been updated for any patients covered by Empire BlueCross:
OVERVIEW
- If no agreement is reached between now and the end of the two-month transition period, Ellis Medicine will not be an in-network provider for those covered by Empire BlueCross. Of course, any Ellis facility will treat you after May 1, but you may be subject to out-of-network rates, which could affect your copay, co-insurance, or other out-of-pocket costs. Please note that the contract termination does not impact all services, such as physician office visits.
- Any Empire BlueCross members with questions on their out-of-network costs after May 1 should contact Empire BlueCross directly.
- For more than four months, the team here at Ellis has engaged in negotiations with Empire BlueCross on a new contract. Such negotiations are standard practice between health insurance companies and hospitals.
- Since last autumn, we have exchanged proposals but still remain far apart on rates. To agree to the rates Empire BlueCross is proposing would deprive Ellis of our ability to continue to provide quality care to our community.
- Of course, we prefer not to take this step with Empire BlueCross, and we realize that this presents a real challenge for some of our patients.
- At issue are unprecedented financial challenges facing hospitals following the Covid-19 pandemic, complicated by new and intense inflationary pressures. This new environment poses existential threats to both Ellis and hospitals across the country. It is only fair that the rates the health insurance companies pay to hospitals reflect this new reality.
- We simply need insurance companies like Empire BlueCross to recognize that the landscape has changed—and changed dramatically—since we last sat down at the negotiating table.
- Ellis will continue to work with Empire BlueCross toward resolving this impasse and bargain in good faith.
- For those who may have difficulty paying increased out-of-pocket costs: Ellis Medicine gladly works with all our patients for a better understanding of their bills. We are also here to provide support and financial assistance if you are having trouble paying. Patients or loved ones may call 518.243.1500 for assistance. We also offer the options of monthly payment plans and applying for financial assistance based upon family size and income.
Q&A
Why is this happening?
The current rates Ellis receives from many payors do not cover the overall cost of care. To elaborate, Ellis receives payments from Empire BlueCross and other insurance companies for care and services provided to their members. The payments are negotiated between the insurance company and the hospital or other providers and are agreed to in a contract. Ellis Medicine and Empire BlueCross have been negotiating a new contract for more than four months, but we remain far apart on these rates and terms.
What does the notice of termination mean for patients?
Any Ellis facility will treat you, and our providers will deliver care just as they always have. However, if you are covered by Empire BlueCross, Ellis Medicine facilities will be out-of-network beginning May 1. That means you may have to pay out-of-network rates. This could affect what you pay in copays, co-insurance or other payments. Ellis’ contract termination with Empire BlueCross does not impact all services, such as physician office visits.
What is the basic disagreement between Ellis and Empire BlueCross?
The inflationary pressures now faced by hospitals are unprecedented, as are the ongoing impacts of the Covid-19 pandemic. Like you, we are affected by the overall rate of inflation on all goods and services. What’s more, hospitals are severely impacted by costs associated with labor shortages, which force us to rely on expensive nursing agencies so we can continue to provide safe care. This is not a local Ellis problem; it is a nationwide problem.
Ellis depends on fair contracts with health insurers to reflect these inflationary pressures in the marketplace. In these negotiations, Ellis is simply seeking fair and realistic payments to protect the quality health care we deliver to you and your neighbors. Health insurers need to recognize that the landscape has changed—and changed dramatically—since we last sat down at the negotiating table.
What happens next?
Ellis believes strongly that an agreement with Empire BlueCross is in the best interests of our patients and community. Ellis is the only hospital in Schenectady County. We approximately 300,000 people in Schenectady, Saratoga, Fulton and Montgomery counties and the broader Capital Region each year.
We will continue to work with Empire BlueCross to reach an agreement that is fair and realistic.
Thank you for allowing the physicians, nurses and staff of Ellis Medicine to provide health care and services to you. We take our responsibilities to you very seriously and are grateful for your trust and confidence in us.
Ellis Medicine | Newsroom
Ellis Medicine Media Inquiries
Media inquiries should be directed to the Communications Department at Ellis Medicine. The Communications Department is open and staffed Monday through Friday, from 9:00 am until 5:00 pm. The department can be reached by phone at 518.232.9288. If you leave a message your call will typically be returned within 24 hours.
All official communications regarding Ellis Medicine are arranged through the Communications Department. We look forward to working with members of the public and media organizations to provide accurate, up-to-date information about Ellis Medicine.
Contact:
Communications
Ellis Medicine
1101 Nott Street
Schenectady, NY 12308
518.232.9288