Thousands of Premera-insured patients in Washington could lose MultiCare coverage |

SPOKANE, Wash. — Thousands of MultiCare patients in Washington state are at risk of losing care if they are covered by Premera Blue Cross Insurance.

The current contract between the two nonprofits expires on May 31; if an agreement is not reached, those with Premera commercial, Individual Exchange and Medicare Advantage health plans will be out of network.

According to Premera, contract negotiations started with a termination notice, which they did not introduce. If passed, all lines of business would be affected, including commercial, individual, UW student insurance and Medicare Advantage plans. Termination would not impact Premera Medicare Supplement or HMO plans with the Sherwood HMO network.

Premera said they will continue negotiating to reach an agreement that benefits everyone but expressed frustrations with the negotiation process.

“We’ve worked hard to reach an agreement with the MultiCare team. That said, MultiCare’s approach to these negotiations has been less reasonable than we would have expected given our history and partnership,” Premera said. “We’re extremely disappointed with the posture and lack of progress in these negotiations.”

The main issue at hand is the amount of money Premera is willing to pay out to MultiCare for the hospital to care for those covered by their health insurance plans.

But MultiCare argued that increased health care costs and inflation warrants a much larger payout.

“Our rates haven’t been keeping up with the primary increases that they’re asking their members… employers…to pay. But out MultiCare Premera rates are also not keeping up with the way they pay other health systems in the state,” Alex Jackson, the Senior Vice President and Chief Executive of the Inland Northwest and Central Valley Regions for MultiCare, said.

MultiCare said they hope to reach a fair agreement that ensures they can continue to deliver “high-quality care.” MultiCare added that for the last five years, Premera has not been holding up its end of the bargain. 

“Since 2019, Premera has reimbursed MultiCare well below the rate of inflation,” MultiCare said. “Patient disruption is not our desire, but we need Premera to cover the true cost of care, so we can invest in the doctors, medical technologies and innovations, and community programs people rely on.”

If Multicare and Premera do not reach an agreement, the following facilities will be impacted: 

• Auburn – MultiCare Auburn Medical Center 
• Covington – MultiCare Covington Medical Center 
• Olympia – MultiCare Capital Medical Center 
• Puyallup – MultiCare Good Samaritan Hospital 
• Spokane – MultiCare Deaconess Hospital 
• Spokane – MultiCare Valley Hospital  
• Spokane – Rockwood Clinic
• Tacoma – MultiCare Allenmore Hospital 
• Tacoma – MultiCare Mary Bridge Children’s Hospital and Health Center 
• Tacoma – MultiCare Tacoma General Hospital 
• Yakima – MultiCare Yakima Memorial Hospital
• Indigo Urgent Care Clinics

If an agreement is not reached, those in these areas must find a new doctor or pay out-of-network costs. Premera said they will work with people with chronic or critical conditions to ensure treatment is not disrupted. 

Approximately 103,000 members would be affected across the state. While approximately 11,000 members would be affected in Spokane.

Patients will still be able to receive emergency treatment if needed. Premera said Emergency care is always covered at in-network cost. In Spokane, Patients can go to Providence Sacred Heart, Providence Holy Family and Shriners Children’s. 

Patients with a Premera Medicare Supplement plan or the HMO plan with the Sherwood HMO network will not be affected if an agreement is not reached.

“We wish it wouldn’t have gotten to this point. But, we really are in a spot during the negotiations that we need to balance, one, keeping the cost of health care affordable for our members that are throughout the state. But then, at the other time, realizing that a key partner in that is our partners at MultiCare, and fairly compensating them for their costs. And so, we have to strike that balance,” David Condon, Vice President for Premera Blue Cross for Eastern Washington and former Mayor of Spokane, said.

For more information and frequently asked questions, visit the Premera website.