Contract negotiations with MultiCare Health Systems

Premera Blue Cross and MultiCare Health Systems are currently in contract negotiations. The contract between the two organizations ends on May 31, 2024, which means if no agreement is reached, MultiCare clinics, hospitals, and providers will no longer be in network for Premera members beginning June 1, 2024.  It is important to remember that MultiCare started our contract discussions with a termination notice. This was not something Premera pursued – we want them to stay in network and our efforts are aimed at that.

If their termination notice goes into effect, that would apply to all lines of business, including commercial, individual, UW student insurance, and Medicare Advantage plans. This does not impact members who have coverage through a Premera Medicare Supplement plan or are on the HMO plan with the Sherwood network.

Current State of Negotiations:

• We received a termination notice from MultiCare on Dec. 22, 2023. That’s how things started.
• Then, many weeks later, only as MultiCare was finalizing their negotiations with another local insurer, did we receive their initial proposal.
• Since then, we’ve offered several counterproposals in the hopes of coming to agreement.
• Unfortunately, MultiCare has responded with double-digit increase requests. This is where they started and where they continue to be.
• It is also important to note that in mid-2022, MultiCare attempted an off-cycle request for a significant increase. We offered a three-year deal with annual increases, but that was declined.
• We remain committed to striking the balance of fair compensation for MultiCare and ensuring access to affordable care for our members. Negotiations are ongoing.

We’ve worked hard to reach an agreement with the MultiCare team. That said, MultiCare’s approach to these negotiations has been less reasonable than we would have expected given our history and partnership. We’re extremely disappointed with the posture and lack of progress in these negotiations.

We approached this negotiation with the same philosophy we always have:

• Use data to help make informed, fact-based decisions
• Fairly compensate the hospital system while remaining competitive in the market
• Keep costs low for our customers

As a reminder, rate increases impact not just Premera, but the communities and people we serve.

Per federal and Washington state regulatory requirements, member letters will be sent starting in April. On April 15, Medicare Advantage members that have seen a MultiCare provider will receive letters notifying them of these negotiations. Then on April 29, all remaining members that have seen a MultiCare provider will receive letters.

If an agreement isn’t reached by May 31, 2024, we will work with members that may need ongoing support due to chronic or complex conditions to ensure their treatment isn’t disrupted.

As we’ve always said, these negotiations are not about Premera, they are about our customers. We serve as their advocate during these discussions as we work with provider partners on practical solutions to keep healthcare affordable and accessible.

To find more information about providers in your network, you can use our Find a Doctor tool or call the phone number on the back of your member ID card.

Frequently Asked Questions:

If an agreement isn’t reached, does this mean I need to find a new doctor or pay out-of-network prices?

In most areas, yes. If MultiCare goes out of network, you will need to find a new in-network provider to continue to typically be responsible only for cost shares and deductibles. An out-of-network provider doesn’t have a contract with Premera, and you may be responsible for all charges, including cost shares and deductibles.

What MultiCare facilities will this impact?

These contracts include facilities in King, Pierce, Spokane, Thurston, and Yakima counties.

The clinics and facilities that would become out of network in the event of a contract termination include:

• Auburn – MultiCare Auburn Medical Center
• Covington – MultiCare Covington Medical Center
• Olympia – MultiCare Capital Medical Center
• Puyallup – MultiCare Good Samaritan Hospital
• Spokane – MultiCare Deaconess Hospital
• Spokane – MultiCare Valley Hospital
• Tacoma – MultiCare Allenmore Hospital
• Tacoma – MultiCare Mary Bridge Children’s Hospital and Health Center
• Tacoma – MultiCare Tacoma General Hospital
• Yakima – MultiCare Yakima Memorial Hospital

What if a member is currently receiving care and their provider is no longer in the network?

Some members may be able to continue their care with their current MultiCare provider at the current in-network benefit level for up to 90 days if they’re receiving treatment for a covered service or for a complex or chronic medical condition. Such conditions include pregnancy or scheduled nonelective surgery. Members can contact customer service at the number on the back of their ID card for more information about this process.

MultiCare is the only hospital in my city. Where do I go?

For some of our members, MultiCare will remain an in-network hospital. The letters we’re mailing to our members will indicate if MultiCare is in network or no longer contracted. You can also call our Customer Service team at the number on the back of your insurance ID card to verify if your provider will be in network after June 1. MultiCare hospitals and providers are still in network until the contract ends on May 31, 2024, if we’re not able to reach an agreement.

How do I find a new provider?

• To find a new provider in your network, sign into your account on  Premera.com. Under Find Care, search the  Find a Doctor tool.
• If you need to find a new, in-network primary care provider, consider Kinwell primary care. Kinwell offers high-quality care just for Premera members in Washington. Same-day or next-day appointments are available in-person or virtually. Find out more at  kinwellhealth.com.

You can find the latest updates on the status of our negotiations with MultiCare on our Healthsource blog.