Blue Cross and Blue Shield of Illinois drops three OSF hospitals, local holders search for answers

PEORIA, Illinois -- Blue Cross and Blue Shield of Illinois announced plans to drop three OSF Healthcare hospitals from it's PPO network.

Saint Francis Medical Center, in Peoria, Saint Anthony Medical Center, in Rockford, and St. Mary Medical Center, in Galesburg, will no longer be a part of Blue Cross and Blue Shield of Illinois' PPO plans, effective January 1, 2018.

"At first I just thought it was something somebody had posted, and it wasn't true. And then somebody else had posted it, and I'm like, now what are we going to do?" says Galesburg resident Lucinda Hensley who is a BCBS insurance holder. She is just one of the thousands of Illinoisans who could be forced to find new health insurance.

"It's just going to make it hard for a lot of people," says Hensley.

According to a release issued by OSF Healthcare on Tuesday, Illinoisans with Blue Cross and Blue Shield PPO plans will only be able to access care at hospitals owned by OSF Healthcare using out-of-network benefits. The one exception is Saint Anthony's Health Center, located in Alton, which will remain in the Blue Cross and Blue Shield of Illinois PPO network.

The coverage will end for OSF hospital services, not specialty physicians associated with OSF. Those will still be covered depending on your doctor.

For more information on what services are covered, click here.

"OSF Healthcare is an accountable care organization committed to population health, which is achieved through ensuring patientshave access to the full resources of its integrated health care delivery system," said Randy Billings, OSF HealthCare senior vice president of population health. "By eliminating three of our hospitals from its network, Blue Cross and Blue Shield eliminates important referral centers and patient access to nearby specialty care - including our children's hospital."

But while Blue Cross and Blue Shield dropped three OSF options, they added a UnityPoint Health option along with Galesburg's Cottage Hospital.

UnityPoint Health - Methodist will join the Blue Cross and Blue Shield of Illinois PPO Network, effective January 1, 2018.

Methodist joins UnityPoint Health - Proctor, UnityPoint Health - Pekin, and UnityPoint Health's physician clinics and home care services, which are already part of the BCBSIL PPO Network.

"Additional choices help bring down the cost of high-quality care," said Debbie Simon, Regional CEO of UnityPoint Health. "Adding Methodist to this network provides a new option for people across the region."

Blue Cross and Blue Shield of Illinois members may direct concerns or benefit plan inquiries to Blue Cross and Blue Shield Customer Service at (800) 538-8833.

Blue Cross and Blue Shield of Illinois issued the following statement regarding the decision:

"Blue Cross and Blue Shield of Illinois is committed to our members, our group customers, as well as the communities we serve. Our current PPO and BlueChoice contracts with St. Francis Medical Center in Peoria, St. Anthony Medical Center in Rockford and St. Mary Medical Center in Galesburg, each a part of the Order of St. Francis Healthcare System (OSF), no longer serve BCBSIL's aim to continue to broaden our members' access to network providers and further enhance our network and product offerings. Our mission is to continue to provide access to quality, cost-effective healthcare in Illinois. That includes creating and designing networks that balance access and affordability of care. We are open to continuing contract discussions with the goal of reaching an agreement that benefits our members and customers." 

You can see the full press conference with Randy Billings, of OSF, below.

Video courtesy of WEEK 25 in Peoria.