Shelby County physicians urge agreement between BCBST, Methodist Le Bonheur Healthcare as negotiations continue

MEMPHIS, Tenn. (WMC) - There’s still no deal between Blue Cross Blue Shield of Tennessee (BCBST) and Methodist Le Bonheur Healthcare on rates the insurance giant will pay and what the local health care provider will charge.

Shelby County doctors tell Action News 5 they can’t stand by while patients have no access to health care.

BCBST and Methodist Le Bonheur Healthcare both say an agreement has yet to be reached.

Meanwhile, doctors in our community worry about the access their patients have to care, as thousands in West Tennessee are still out of network.

Doctors with the Memphis Medical Society say it’s time for Methodist Le Bonheur Healthcare and BCBST to reach a new agreement.

“It’s really a travesty... our patients and families may not have access to the services that can potentially be life-saving,” said pediatrician Dr. Jason Yaun.

Dr. Yaun is one of 2,350 physicians in the organization who believes the lack of a deal will have a detrimental impact on the health care outcomes for patients.

“We know that we offer services that are not available for many children and families for miles around, and it does concern me that we have a large number of health disparities in our community and we have a large number of children who need access to this care that may suffer because of the situation,” said Dr. Yaun.

Seven-month-old Nathan Hart is one of those said children.

His parents Melanie and Tyler Hart reached out to Action News 5 earlier this month after they were told Nathan’s bilateral cochlear implant surgery at Le Bonheur Children’s Hospital was canceled.

“The doctor come in again and said, it’s not covered, but we’re doing the surgery,” said Melanie Hart.

Shortly after Action News 5 spoke with The Hart’s, little Nathan’s surgery was rescheduled after they spoke with the insurance giant, but many families may not be as lucky.

According to the state of Tennessee, almost 179,000 people in West Tennessee are covered by BlueCare.

As of November 2022, almost 54,000 people across the state are covered by TennCare Select, part of BCBST.

All of those customers are now out of network, restricting access to Methodist Le Bonheur health care facilities, including hospitals, centers, care services and more.

“As a pediatrician and as a parent, I want what’s best for children and our community and of course, children don’t have a voice so as physicians and as adults and parents we have to stand up and be their voice and advocate for them in the best care available for them,” said Dr. Yaun.

Methodist Le Bonheur Healthcare sent Action News 5 the following statement:

“Negotiations are ongoing with BCBST to reach a resolution that benefits all patients. However, we understand that some employers such as the City of Memphis and St. Jude have made special arrangements with BCBST to remain in network for at least 30 days pending the outcome of negotiations. We encourage other employers and their respective employees to reach out to BCBST to request the same special exemption.”

Blue Cross Blue Shield of Tennessee told Action News 5:

“The most important thing we want to share is that BlueCross is here to help our members get the care they need. If anyone has questions or needs assistance scheduling health care services, they can reach out to us by phone or even use live chat on our website (bcbst.com) and mobile app.

For most care needs, we can connect members with other high-quality providers in the area. And we’re diligently evaluating unique situations that involve requests to continue covering specialized care at LeBonheur.”

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