2/23/2023 Update
Many patients and concerned citizens have asked questions about the coverage for emergency care and the coverage for an ongoing treatment plan such as OB and cancer treatments. We have updated our Q&A section to address those topics. Click here for that updated information.
1/18/2023 Update
As of today, there has been no further communications with BCBS. We have set up some resources to help answer questions for those impacted by the BCBS failed negotiation process, including a list of FAQs, a hotline to leave a voice mail (405 533-8833) and a dedicated email (questions@stillwater-medical.org). In order to provide the most accurate response, please leave a detailed message. Messages and voicemails will be responded to within 2 business days.
Again, we know this situation has caused anxiety and frustration. However, we can reassure you that we are diligently working toward an outcome that is beneficial to our patients and the Stillwater Medical Health System.
1/3/2023 Update
The previous contract between Stillwater Medical and BCBSOK expired on December 31, 2022, and terms have not been agreed upon to sign a new contract for 2023. We have now entered into a 120-day extension that will end April 30, 2023, at midnight. At that time, Stillwater Medical will no longer be in network with BCBSOK.
We apologize for the anxiety, frustration and inconvenience this challenging situation is causing. As always, Stillwater Medical will be here to provide compassionate and quality healthcare services to all of our patients. Please know that we are doing everything possible to work through this situation with as little disruption as possible.
Blue Cross Blue Shield of Oklahoma Update
- Stillwater Medical has been contracted with Blue Cross Blue Shield of Oklahoma (BCBSOK) for many years and we have enjoyed a mutually respectful relationship which has been beneficial to our patients and the communities Stillwater Medical serves. Since September, Stillwater Medical has been actively working on contract negotiations with BCBSOK to ensure our patients will continue to have access to quality healthcare services at our hospitals and clinics. These negotiations, which include but are not limited to increased payments for services, are necessary due to historic rapidly rising costs of healthcare since 2019, pre-pandemic. On Tuesday, December 20, 2022, negotiations reached an impasse.
- This impasse with BCBSOK means we must make some difficult decisions. As a not-for-profit, stand-alone, sole community hospital, it is crucial to ensure sufficient funding for operations. Despite this very challenging situation, Stillwater Medical continues to provide all patients with safe, compassionate care. Stillwater Medical’s mission is “to provide compassionate and quality healthcare services. In our commitment to excellence, we will be responsive to the needs of people in the region we serve and will do so in a financially sound manner.”
Life-Saving Healthcare When It Counts
- When your life is hanging in the balance, you need a local hospital to provide the care you need 24/7/365. It can mean the difference between life and death.
- In the Stillwater area, thousands of families turn to Stillwater Medical when they are most in need.
- Coming to Stillwater Medical means gaining access to high-quality diagnostic and life-support services.
- Stillwater collaborates with physicians and clinicians that have the necessary training and extensive experience to save lives.
The Real Cost of Hospitals:
- There are significant expenses related to the operation and administration of a hospital, such as appropriately supporting its staff, its physician network, maintaining and ensuring top quality and cutting-edge equipment, and ensuring a safe environment for its patients that promotes healing.
- Unlike other types of healthcare services, hospitals provide lifesaving care and are clinically complex:
- At all times hospitals must be ready to treat any kind of healthcare condition, ranging from trauma to child delivery to heart attacks – all at a moment’s notice.
- Unlike other healthcare, hospitals must remain open and staffed with highly skilled clinicians 24/7/365.
- To provide the highest quality care possible, hospitals must have at their disposal a full suite of diagnostic and life support services which are administered in most cases by board-certified physicians.
- Stillwater Medical Center will not turn a patient away because they may or may not be in-network with a specific carrier. Stillwater additionally welcomes Medicare and Medicaid patients. These costs and expenses require fair reimbursement by insurance companies in order to maintain the quality of care to its patients.
- Stillwater and hospitals across the nation have seen historic cost increases, and many hospitals are closing facilities due, in part, to the increased cost of maintaining the facilities, which has the potential to impact the quality of care provided to patients.
The Current Situation: BCBSOK Network Contract Expiration
- Stillwater Medical Center’s costs have increased 26% from pre-pandemic costs, patient adjusted. This is unprecedented. Stillwater is asking for nothing more than our cost increases in order to appropriately administer our hospital and staff and be able to continue to treat our patients with the same high-quality care.
- To rebut BCBSOK’s assertion that “Stillwater demanded increased reimbursement that was several times higher than the rate of inflation compounded over three years,” Stillwater asserts that BCBSOK’s offer of reimbursement during the most recent contract renewal negotiations has not paced inflation - this puts our hospital community at risk. Stillwater asked that BCBSOK pay an increase which paces inflation and meets Stillwater’s cost increase needs – this has been repeatedly articulated to BCBSOK.
- Additionally, Stillwater asserts that BCBSOK’s rate offers were objectively unreasonable and rebutted by Stillwater’s financial modeling. Stillwater repeatedly disputed BCBSOK’s calculations and has offered significant financial data to support its position.
BCBSOK’s offer would provide Stillwater with less than half of our verified and documented cost increases
- If Stillwater renewed its contract with BCBSOK at the rates offered, it would not be able to continue to deliver the same level of quality care and service offerings that our Community currently enjoys today, given that the collective rate payments for BCBSOK’s patients, comprising 21% of Stillwater’s patient base, would not allow for Stillwater Medical to continue to administer and staff the hospital to the level it needs to be able to provide the quality of care its patients so desperately need and deserve.
- In the event a compromise cannot be reached by December 31, 2022, Stillwater Medical facilities will no longer be a BCBSOK in-network provider effective May 1, 2023. This means that patients covered by BCBSOK may either not have coverage for non-emergency medical services at our facilities or may be required to pay higher out-of-network co-pays and deductibles for those services.
- BCBSOK members and other patients at Stillwater would have attenuated quality of care if Stillwater accepted non-viable and non-sustainable rates that cannot support the hospital’s costs.
- Stillwater has articulated to BCBSOK, and would still be, willing to remain in-network should BCBSOK consider paying rates that are viable to Stillwater and based upon appropriate inflation modeling, as well as addressing other contractual concerns.
- Stillwater Medical Center is contracted with many other Commercial Payors who contract for rates and provide contractual language that are in line with Stillwater’s needs to continue its ongoing mission of providing quality care to the patients we serve.
- Note that Stillwater Medical's service has earned, among other accolades, a 5-star ranking by CMS, a World’s Best Hospital ranking by Newsweek, a top decile national performer in patient satisfaction as noted by Press Ganey, and ranked in Modern Healthcare’s Best Places to Work for 11 years in a row. We are looking to maintain the quality of care that earned these high recognitions.
- Stillwater allows for the local community to stay close to home for treatment such as a 512 Slice CT, 3.0T MRI, PETCT, 3D Mammo, Cath Labs, Robotic Surgery, 4D Ultrasound, state-of-the-art surgical suites, and opening May 2023, the only MRI Linear Accelerator in the state offering the latest technology in radiation treatment for cancer patients. We need to be able to continue to fund these services and keep our equipment up to date and in good order.
- We additionally offer services that benefit the Community but do little for the profitability of Stillwater, such as our diabetic clinic, psychiatry clinic, 24/7 Emergency care staffed by board-certified physicians, 24/7 ICU care, 24/7 Hospitalist care for inpatients and newborn delivery services with hope to expand to NICU services in 2023.
In Conclusion: What you need to know
- Stillwater Medical is critical and essential to those who call Stillwater home.
- It is a highly specialized facility that provides complex clinical care, which is unique.
- We do our part by providing patients with life-saving care. We are asking BCBSOK to do its part and ensure that the care to its members is not attenuated by the inability for the hospital to provide quality care. By its methodology and the resulting need for Stillwater Medical to currently decline renewal of its contract, BCBSOK members will, unfortunately, be left with coverage gaps.
- For additional information, email publicrelations@stillwater-medical.org
Supporting Documentation
- Article by Becker's Hospital Review - 631 rural hospitals at risk of closure by state
- AHA Exp Growth 2019 - 2021 (pdf)
- Kaufman Hall - Oklahoma Report (pdf)
- Kaufman Hall - National Hospital Flash Report - Nov. 2022 (pdf)
- Stillwater Medical Cost Specific Increases 2019 to 2022 based on Adjusted Patient Days (APD)
- Definitions of APD - the sum of inpatient days and equivalent patient days attributed to outpatient services. (image below)
