Confluence Health severs contract with Premera, state’s second-largest health insurer

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WENATCHEE — North Central Washington’s largest healthcare provider announced Tuesday it will no longer accept insurance from the state’s second largest provider of health plans.

Confluence Health will end its contract with Premera Blue Cross over what it calls “Premera’s unwillingness to pay a rate that is consistent with other commercial payers in the market.” The healthcare network, which includes Central Washington Hospital and the Wenatchee Valley Clinics, says it notified Premera of the decision April 23.

“We did not take this decision lightly,” incoming Confluence Health CEO Dr. Doug Wilson said in a press release. “As a non-profit health care system, we must remain good stewards of the resources we have. Accepting the current terms proposed by Premera would not allow us to do this and could ultimately lead to decreased availability of critical health care services in the area.”

Confluence says the contract was negotiated for months before its board of directors decided to sever the contract, and there are no more meetings scheduled between the healthcare provider and the insurer. Premera spokesperson Courtney Wallace said the company believes a new contract can still be negotiated.

“We fully believe we can reach an agreement with Confluence that provides the people we serve with affordable, high-quality healthcare,” Wallace said in an email to NCWLIFE. “Despite Confluence’s decision to end the negotiation, we believe it is in the best interest of our customers and the community, that we continue these critical conversations as this type of discussion takes time and isn’t a sprint.”

The separation becomes effective Feb. 1. Patients covered by Premera plans after then would be considered out-of-network, and their personal costs for medical service at Confluence could be considerably higher.

Wallace says Premera insures roughly 40,000 individuals and employers in Chelan and Douglas counties. She said it’s untrue that Premera refused to offer competitive rates for Confluence Health, and pointed to Confluence’s stature in NCW and its lack of sizeable competition for patients.

“On average, Confluence Health’s hospital costs are higher than all other systems in Eastern Washington. There are 12 other health plans that compete aggressively with us in the market.”

Confluence says it decided to give a six-month notice to allow time for affected patients, insurance brokers and employers “to review their health care benefit options and take advantage of upcoming enrollment periods to make these important decisions about their health care coverage.”

Confluence Health is the nonprofit umbrella for Central Washington Hospital and the Wenatchee Valley Medical Center, as well as clinics in Omak and Moses Lake. It employs about 3,000 people.

Premera Blue Cross holds the second-largest market share of any health insurer operating in Washington, at 11.87 percent as of 2020, according to Washington’s Office of the Insurance Commissioner. Only Molina has a bigger share, at 13.47 percent.