If you have Florida Blue as your primary health insurance carrier, you have likely received a notice in the mail about who your (and/or your kids’) new primary doctor will be if Baptist Health and Florida Blue don’t reach an agreement by September 30, 2024. For most of us, who pay a lot of money for good health insurance, this notice likely came as a surprise and maybe even a catalyst for panic and an onslaught of questions. So, what does this mean?
Florida Blue and Baptist Health are currently at a deadlock in their negotiations on what rates Florida Blue will reimburse Baptist physicians and facilities for their services. If they can’t come to an agreement by September 30, Baptist Health and physicians will no longer accept Florida Blue health insurance, which will mean that for all Florida Blue customers, Baptist Health (and Wolfson Children’s Hospital for us mamas) will lose in-network services at these providers and facilities. If your kids, like mine, currently have a pediatrician through Baptist Health, they will lose their in-network provider and we will have to find new pediatricians. Same with us as adults — if your primary care physician is through Baptist, you will be left looking for a new PCP to provide your care. Additionally, this will shift all Baptist hospitals and consequentially Wolfson Children’s Hospital from in-network to out-of-network. If you’re wondering why this matters, please keep reading.
For me, like many other mamas, this means that the pediatricians to who I have chosen to entrust the care of my children will no longer accept our insurance and therefore, will not be able to see my children for care. For my 3-year-old, this means that the doctor she’s seen since she was born will no longer be her primary provider. For my 7-year-old, this means that the doctor who he’s seen for 3 years, who is also the only physician who has managed his medications for ADHD, will no longer be his care provider. For me, as their mom, this means that the trust I’ve encouraged my kids to have in this specific doctor, Dr. Knight at Baptist Pediatrics, will serve no purpose.
My children, and myself, will have to begin the search for a new provider who we all trust, feel safe with, and have confidence in. If you are a parent, you know that there is no greater level of trust than that which you allow someone to have in caring for your kid(s). For kids, who are still learning which adults are safe and who they can trust, breaking the continuity of care is not only unfair but is also a deterrent to their healthy development. I, unlike many mamas, have the “luxury” of my children being on the younger end of the 0–18 age spectrum, so my children will have some time to reestablish a relationship and trust with someone new… but they shouldn’t have to. For parents whose children are in their teen years — entering puberty, some of the most delicate times medically, hormonally, etc. — this disruption in care continuity could be detrimental. Research has shown that having continuity in care is not only a preference and priority of patients and their families but is also positively correlated with health outcomes.
So what’s at stake if Baptist Health and Florida Blue don’t reach an agreement? Our kids’ health is at stake. Continuity of care isn’t the only thing that will be impacted by the absence of an agreement between the two entities. The availability of care will be disrupted, specifically the availability of emergent, urgent, and/or critical care. Wolfson Children’s Hosptial, a Baptist Health hospital, is the “only full-service tertiary hospital for children in the region” and is where the vast majority of parents in Northeast Florida take their kids for emergency care, where Nemours physicians and specialists perform surgeries, where many NICU babies are cared for, where children battling life-threatening diagnoses like cancer and leukemia receive infusions, and so much more. If you asked me right this very minute where I would take my children in the case of an emergency, Wolfson Children’s Hospital would be my answer. If you then told me that hospital was no longer an option for me, I don’t think I’d even have an answer. I’ve never heard of anyone else taking their children to any other hospital for emergent care. The options for high-quality care will drastically decrease for those of us with Florida Blue as our healthcare insurance if an agreement isn’t reached.
Earlier this year, my then 2-year-old had a very bizarre health scare, and I picked her up from preschool and immediately rushed her to the emergency room at Wolfson Children’s Hospital. What I thought would be a relatively quick trip turned into an admission and three-day stay. If you’ve ever been in the hospital with a toddler, you know it can be absolutely horrible. It’s torturous for a small child with so much energy and zest for life to have to stay in a hospital room with IVs in their arms, constant interruption of sleep for updated vitals, and what feels like a deprivation of any ounce of normalcy for them. After the initial admission, once we got to her room, I quickly realized how incredibly lucky we were to be at Wolfson Children’s Hospital. My sweet girl was greeted by the sweetest child life specialists and most patient nurses, and she got to visit the playroom on her floor during open hours. She loved painting a wooden car and countless pictures with their Art with a Heart program, and even has a favorite giraffe photo that one of the incredible art facilitators hand-painted for her. It would be a lie to say that any hospital stay with my children is “fun,” but it would also be a lie to say that Wolfson Children’s Hospital wasn’t the best place we could’ve been during those three days.
In addition to the availability of emergency care decreasing, what do you think is going to happen if all Florida Blue customers currently seeing Baptist Health Pediatricians have to find new pediatricians? The demand for pediatric primary healthcare will increase for all other pediatricians in the area, and as those other pediatricians’ patient numbers rise, there will be a decrease in the availability of providers who are accepting new patients. It will take longer to get a sick appointment and/or a preventative healthcare visit. If your child is sick and their pediatrician can’t see them (or you can’t find a pediatrician who takes your insurance), where would you end up taking them? The only other options are an urgent care facility or the emergency room at a hospital, the options for which we’ve already established will be significantly fewer.
What You Can Do
A negotiation between these two entities isn’t just advisable or desired, it’s critical. Because while the executives of Florida Blue and Baptist Health sit in rooms negotiating reimbursement rates, our children’s access to quality healthcare quite literally hangs in the balance. Here are a few things you can do to help:
- Call Florida Blue at the number on the back of your insurance card and tell them how important it is to you and your family to maintain in-network access to the Baptist Health facilities and doctors you know and trust.
- Talk with your employer. If you get insurance through your employer, tell them how important in-network access to Baptist Health and Wolfson Children’s is to you and your family, and encourage them to call or email Florida Blue.
- How will you know if we reach an agreement? Baptist Health will communicate important updates to the mailing address, email and/or phone number listed in your patient portal, My Baptist Chart. Sign in or activate your account at my.baptistchart.com.
- Still have questions? Call 904.202.3247 to speak with a Baptist Health representative.
Florida Blue has already stated very clearly that they would continue to cover all children at Wolfson no matter what the outcome of the negotiations is. Watch the link below.
https://m.youtube.com/watch?si=8_TFWCfreBs-26rg&embeds_referring_euri=https%3A%2F%2Fwww.floridablue.com%2F&embeds_referring_origin=https%3A%2F%2Fwww.floridablue.com&source_ve_path=MTY0OTksMjg2NjQsMTY0NTA2&v=CBifwgtq_rE&feature=youtu.be