Springfield Clinic rolls out a health plan that gives patients in the network access to doctors.
The move comes after last year’s dispute with Illinois-based Blue Cross Blue Shield, which forced at least 55,000 customers to seek new healthcare providers.
It is the first time Springfield Clinic has offered such a plan in its more than 80-year history.
“We’re giving employers and patients back control,” said Zach Kerker, Springfield Clinic’s vice president of brand experience and advocacy.
The health plan and a website starts this week.
Called the “Advantage Plan,” it is available to employers with 10 or more employees in central Illinois and includes all Springfield Clinic providers. The plan also provides Tier 1 access to a nationwide network of hospitals and providers through the national insurer HealthLink.
The plan’s approval wasn’t a specific response to the Blue Cross situation, Kerker said, “but it probably accelerated our need to do something like that.
“We’ve heard from providers and patients who have asked for a more direct relationship with Springfield Clinic,” he added. “This plan provides that. It guarantees that you will never be without network with your Springfield Clinic physicians. It was developed locally by people who understand the care needs of patients in central Illinois. Ultimately, it is just another way for patients to access to their healthcare provider. Many patients have felt that there have been barriers to their physician recently and this provides a way for patients to get back in.”
Springfield Clinic partnered with Consociate Health Decatur to develop the plan.
Many traditional health insurance plans limit a patient’s ability to make health care decisions, says Darren Reynolds, CEO of Consociate Health.
If a person needs a colonoscopy, Reynolds said, the team will work with the person to get that procedure done quickly, safely and in the most cost-effective way.
“Many procedures cost much less in an outpatient surgery center than in a hospital, and patients should know that ahead of time,” Reynolds said.
Springfield Clinic’s removal resulted in at least 55,000 Blue Cross customers having to find new doctors or submit continuity of care requests to Blue Cross, though Springfield Clinic officials put the number at double that.
Kerker said the Springfield Clinic number came from every patient who had received services in the past three years and had Blue Cross.
Blue Cross wash fined $339,000 for violating the Network Adequacy and Transparency Act, a 2017 state law.
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