MURRAY — Over the past several weeks, there has been a rumor spreading throughout the community that Murray-Calloway County Hospital is not receiving patients insured by the Anthem Health Plans of Kentucky (Blue Cross) group, due to a contract dispute between the two parties.
Tuesday, hospital CEO Jerry Penner told The Ledger & Times this is not true and added that he wanted to go to the media because of, among other things, the numerous phone calls being made to members of the Murray-Calloway County Public Hospital Board of Trustees. Officials with the City of Murray and Calloway County governments are also having to answer questions that Penner said do not have good answers right now. He also was trying to quell this rumor so MCCH and its associated practices are not losing patients.
“There are questions out there,” Penner said of the dispute that began in October when Anthem sent the hospital its proposed contract for the upcoming year. The current contract expires on Feb. 15, 2020, but Penner said that because the new proposal showed a continued drop in reimbursements to the hospital, the hospital opted to terminate its current contract.
That has caused confusion, with many patients suddenly believing that this termination means all connections with Anthem are severed, leaving those patients in limbo.
“We still take Anthem. We will continue to take Anthem. I think some of our patients have been told, ‘Oh, the hospital is not taking Anthem anymore.’ That’s not true,” Penner said. “We just want to clarify that and we will continue to take care of our patients that take Anthem, even after our deadline on the contract expires on Feb. 15, 2020.
“We literally have had patients call our offices and say, ‘Well, you don’t take Anthem … I can’t go down there and get enrolled to have my baby with you.’ So, it’s in the community. We don’t know where it’s coming from, but we’re very uncomfortable with the fact that it’s happening and it shouldn’t be happening.”
Penner said one reason this has become a rather widespread issue in the community is because of how many patients have Anthem as their provider. Even more important, though, he said, is who Anthem serves — major employers locally, including some of its banks, both the Calloway County and Murray school districts, an industrial facility and the largest employer, Murray State University.
“That’s why when all of this started, I took the time to call all of the heads of those places to tell them that we were terminating our contract, so they would be aware something was happening,” Penner said on Tuesday.
Having satisfied his goal of informing the public that MCCH is continuing to serve Anthem patients, Penner then gave a synopsis of how this issue started in the first place. He said it is a problem that hospitals throughout the nation are facing, not just independents like MCCH.
“Myself and (MCCH Chief Operations Officer John Wilson) went to a conference a few months ago (in Chicago) and it included the CEOs of just about every major place you can name, including Mayo, the Cleveland Clinic, you name it. Every one of us were discussing reimbursements,” he said. “Look at all of the commodities out there — meat, eggs, cheese — it doesn’t matter which one you choose, those prices have risen. Well, it’s the same with hospitals.
“Our medical supplies costs have gone up, salaries for nurses and other professional and support staff have gone up, the costs of drugs have gone up, the costs of medical equipment have gone up. They’ve all gone up in the last 10 years, yet one of the things that hasn’t gone up is the reimbursement rates we get in certain areas of the hospital.
“If we’re going to continue to exist as an independent hospital, which is a charge I have given to my board; we certainly must require our partners out there to adjust with the times to ensure our fiscal viability.”
Penner said negotiations are ongoing and will continue. He warned patients to not be surprised if those negotiations have to continue past the Feb. 15 deadline.
“We’re a community-owned hospital. We take care of those who can’t take care of themselves; that’s what we do and we don’t turn people away,” he said, noting that the hospital, while owned by the people of the community, does not receive any tax funding from the community. “So (people) can’t say, ‘Well, that’s my tax money at work.’ No it’s not. Murray-Calloway County does not derive any tax benefit from the community whatsoever. It’s all eat what you kill. We do business, we earn money, we try to keep our head above water, but, as I said, costs have risen.
“Whether it’d be to put a roof on this building or a new linear accelerator for (the Regional Cancer Center) in the future or replacing a lot of things that are important to us and our physicians so they can do their diagnostic work, those charges have gone up and the rates of reimbursement have not risen and, in some cases, they have been cut back by payors out there. It’s not the fault of anybody. It’s just inflation, but to keep us whole, we need to have our commercial payors out there doing their jobs and letting us do what we need to do.”
Penner said Tuesday that he feels confident the dispute will end with a new contract that the hospital can accept. He said a senior executive with Anthem told him, “We’ll get there. Things will get worked out.”
“We’re just not there yet,” Penner said.
In a letter Penner sent to various parties last week, he said that while MCCH will continue to take Anthem patients after Feb. 15, most health plans in the area have a payment for out-of-network benefits. He said that, generally, this means entities and their employees can access MCCH services but possibly with different benefit levels.