Patients caught in the middle of NCH and Florida Blue negotiations

Patients are worried they’ll have to find new doctors if Florida Blue and Naples Comprehensive Health cannot reach an agreement.

The two companies have been at odds with one another for months, and now the deadline for a deal is rapidly approaching, with patients hanging in the balance and feeling left in the dark.

When Marcel Ebersbach first got the letters that his family’s health provider and insurance were struggling to renegotiate, he didn’t bat an eye.

“I wasn’t really concerned because I thought, ‘okay, they’re gonna solve it anyways,”” said Ebersbach.

But with no solution and only days until the October 1 deadline, he and many other patients are nervous about losing their doctor or having to pay more to keep them.

“We are the ones who are kind of trapped and tied to both of them,” said Ebersbach.

Trapped between Naples Comprehensive Health and Florida Blue.

“This is a haggling. This is waiting to see who’s going to give first. Again, the hospital has to be able to negotiate a fair contract to maintain services,” said Dr. Betsy Brothers, Chief Medical Officer NCH North Campus.

If no agreement is reached, Ebersbach told WINK News he knows what he’s choosing:

“We want to stick to the doctor. Yeah, because it’s a thing of trust, not only for us but also for the kids,” said Ebersbach. “I’d rather pay out of pocket instead of going elsewhere. “

Brothers tells WINK News prices will jump, and how much varies depending on the patient.

“Some out-of-network plans aren’t going to be that significant. Some out-of-network will be very extensive,” said Brothers.

WINK News has reached out to Florida Blue with some of these concerns.

The insurance company responded with a statement that says, in part, “NCH is demanding increases of more than 30%, which far exceeds inflation and medical inflation data.”

It goes on to say, “If NCH chooses to leave our network, we’ll ensure a seamless transition to other high-quality providers in the area.”

“At the end of the day, we are customers of Florida Blue; we are customers for the NCH, so they should decide in favor of the patients,” said Ebersbach.

WINK News reached out to NCH for a statement on Monday.

A spokesperson responded with the following quote:

“NCH continues to proactively negotiate with Florida Blue to resolve contract terms with the insurance company. The system is seeking fair reimbursement from the insurance company to cover the rising cost of patient care and preserve local access to doctors and vital services for families across Southwest Florida.”

The statement continued to mention the following:

“If Florida Blue forces NCH out of network and refuses to pay our community healthcare system fairly, thousands of patients will be without access to local doctors and specialists,” said Betsy Brothers, MD, NCH North Hospital Chief Medical Officer. “As the only birthing center in Collier County, it’s critical that Florida Blue recognizes the role NCH plays in community health and listens to the patients and their customers, who depend on us when they say they want – and need – to keep their doctors in-network. We hope Florida Blue recognizes that and does the right thing.”

Reporter Maddie Herron spoke to a representative from Florida Blue Monday, who provided WINK News with the following statement from Phil Lee, West FL market president of Florida Blue:

“Florida Blue is negotiating on behalf of area members and employers to protect their right to health care that is as affordable as possible. NCH is demanding increases of more than 30%, which far exceeds inflation and medical inflation data. We have a fair offer on the table that is market competitive, considers inflation, accounts for rising labor costs, and offers NCH annual rate increases.

While we have a great deal of respect for the doctors, nurses, and staff at the NCH hospitals and facilities – we need their administration to listen to reason. Florida Blue believes in value-based care that prioritizes keeping people healthy. NCH leaders have repeatedly demanded more money without taking accountability for improving patient health outcomes.

If NCH chooses to leave our network, we’ll ensure a seamless transition to other high-quality providers in the area. Emergency services will still be covered at in-network rates, and our members can always access care from the nearest hospital in case of a medical emergency.“

There is less than a month until the October 1 deadline, which could force many customers to make a tough choice about their healthcare. WINK News will continue to check-in with both parties leading up to the deadline.