Regence faces backlash over ending PPO benefits

Regence BlueCross BlueShield of Oregon's recent announcement that the insurer is ending its PPO benefits is not sitting well with members.

Regence in April announced that it had entered into a partnership with Adventist Health and Tuality Healthcare. The partnership stipulated that beginning Oct. 1, select Regence individual members would be transitioned from their current PPO network to one of two Oregon Select networks, according to a Regence statement. Under the arrangement, Regence reduces its extensive provider network in Clackamas, Multnomah, Washington and Yamhill counties and only contracts with the roughly 1,100 physicians aligned with Tuality and Adventist, according to a report in The Oregonian.

Members will be transferred to the new network when they renew their coverage, meaning about 20,000 Oregonians will find their current PPO network of physicians and hospitals ending on Oct. 1. Members will be transitioned to the provider networks at Tuality or Adventist, unless they elect to pay more to see what will become an out-of-network physician of choice or switch insurers, according to The Lund Report.

In its news release, Regence said the change was "designed to provide members continued quality care and monthly premium affordability," but not everyone is viewing it that way.

"I'm guessing that most people who received this notice haven't quite grasped its significance yet," Regence member David Weissman told The Oregonian. "I assume that most people like me joined Regence because they wanted a wide range of choices, and those choices are being almost completely eliminated."

Weissman is not the only member to express frustration. Insurance agent offices are receiving numerous angry phone calls from members. "People are particularly unhappy about losing their own physician and are calling us and sending emails," Richard Skayhan, an agent who works for Leonard Adams Insurance in Portland, Ore., told The Lund Report. "We're sending them over to ODS (Oregon Dental Service) because their rates and design coverage are the best in the area."

While Regence acknowledged its news impacts many members, Don Antonucci, president of Regence BlueCross BlueShield of Oregon, said the insurer will work to make the transition as smooth as possible. "Providing affordable coverage is one of our top priorities at Regence. Both the Adventist and Tuality health systems are collaborating with us to deliver quality care at an affordable price. We know the doctor-patient relationship is personal, and this may mean a change for many of our members."

It's not only members who are unhappy with Regence's decisions. The insurer has recently come under fire from consumer advocates. The executive director of National Alliance on Mental Illness Oregon questioned Regence's recent announcement that it will reduce mental health benefits and impose a higher deductible for medical care and prescription coverage, which would affect about 30,000 Oregonians, according to The Lund Report. The Oregon State Public Interest Research Group (OSPIRG) called this announcement "bad news for consumers," according to The Lund Report. Earlier in the year, OSPIRG issued a news release expressing concern about a Regence proposal to raise the insurance rates for small businesses.

For more information:
- see the Regence statement
- read the Oregonian article
- here's the Lund Report article on member reaction and the article on mental health benefits
- see the OSPIRG statement

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