Are you as tired as I of the continuous onslaught of commercials from Blue Cross / Blue Shield of Louisiana, often followed by a rebuttal commercial from the Franciscan Missionaries of Our Lady Health System?  BCBSLA makes a compelling appeal to our emotions during these financially difficult times, indicating that they have offered a reasonable increase to the Franciscan Missionaries despite their being the most expensive healthcare provider in the state, to which the Missionaries reply that they provide unique services not available through other providers, and at a reasonable cost.

 

 

Blue Cross has indicated that facilities within the Franciscan network only spend about 55 cents of every dollar on direct patient care.  The Franciscan Missionaries have replied that its hospitals

 

“offer unique services to their markets, and Catholic mission work related to health care that other systems don’t.”

 

I’ll state for the record that I have not audited anybody’s books, and that this is an opinion piece and not an investigative piece.  I do know that every time I pass a facility operated under the Franciscan umbrella, there seems to be construction going on.  And this construction is not necessarily limited to additional hospital beds, for as often as not it might be office space for lease to the private practices of medical professionals.  I’ve heard on more than one occasion that not only do these spaces offer advantageous locations, but they also offer advantageous pricing that other investors can’t compete with.

 

I also wonder that my insurance should pay for “Catholic mission work.”  Should that not be funded by tithes and offerings to the Church?

 

Is this how a “not for profit” healthcare provider should operate?  If they are making so much excess revenue (can’t call it “profit”) that they must reinvest in new construction, why can they not simply reduce the costs of their services to patients, and thus accept less generous contracts from insurance companies? 

 

And not only do they have funds to invest on ongoing construction, but according to this letter to the Baton Rouge Advocate, they can pay people to make unsolicited calls to former patients to lobby their cause.

 

What’s really at stake here?  The Franciscan Missionaries are at risk of losing a significant volume of business if Blue Cross is forced to require its members to pay out-of-network rates for routine care at their facilities.  Blue Cross may lose a few members if those members insist on utilizing Franciscan facilities, but those losses may be offset by new membership drawn by lower costs.

 

Will the overall quality of patient care suffer?  Any answer would be entirely subjective, but Blue Cross has made it clear to the Monroe Newsstar that

 

“those insured by Blue Cross would still be able to access St. Francis’ unique market services, such as a neurosurgery intensive care unit and a Level III neonatal intensive care unit, at in-network prices even if a deal isn’t reached.”

 

Facilities affected by this negotiation, for which Blue Cross indicates they’ve extended their best and final offer, are St. Francis Medical Center in Monroe, Our Lady of the Lake Regional Medical Center and The Tau Center of Baton Rouge; St. Elizabeth Hospital, Gonzales; Our Lady of Lourdes Regional Medical Center, Lafayette; Heart Hospital of Lafayette; and Assumption Community Hospital in Napoleonville.

 

This standoff between the two parties is not unprecedented, as a similar negotiation went down to the wire in 2008.  And regardless of the outcome, we won’t be hearing those commercials beyond the end of January when the existing contract expires.