Doctors Protest Reimbursement Rates, Drop Blueshield Insurance Company Says New Payment Plan More Equitable And Saves Money

More than 55 Idaho doctors have decided to stop accepting Regence BlueShield of Idaho insurance starting today to protest the company’s new reimbursement rates.

Other physicians are planning to follow their example.

The protest will force thousands of patients to either switch doctors, change insurance plans or pay more out of pocket, said Bob Seehusen, the executive director of the Idaho Medical Association.

BlueShield covers 330,000 people in Idaho.

Spokeswoman Georganne Benjamin said the new system, though unpopular now, will make pay more equitable and lower overall health care costs in the long run.

No Coeur d’Alene doctors have notified the Lewiston-based company they will no longer accept BlueShield reimbursement as full payment, she said.

Beginning Sept. 1, BlueShield will change the way it pays doctors for services provided under its traditional fee-for-service contracts. The changes do not affect payments for services provided to health maintenance organization members.

Benjamin said the new system was adopted in response to physician requests for a publishable fee schedule that clearly indicated compensation for each procedure.

BlueShield will pay doctors set fees for each exam or procedure rather than a percentage of the doctors’ charges. The fees are based on a formula that takes into account work required, practice expense and malpractice costs. As a result, many general practitioners’ payments will go up, while some specialists’ payments will go down.

BlueShield estimates that 78 of 1,500 doctors statewide will see an immediate drop of 10 percent or more in payments, while 54 will receive increases. But BlueShield officials said the doctors facing cuts, mostly specialists such as radiologists, orthopedists and cardiologists, still will be paid more than the regional average.

Specialists are the ones dropping BlueShield, Benjamin said.