Latest offer to WellNow is lower than a decade ago
SYRACUSE, N.Y., Dec. 29, 2023 /PRNewswire/ — The latest offer from Excellus BlueCross BlueShield to Upstate New York’s largest urgent care services provider is less than it paid ten years ago while over the same time period has convinced New York State to raise its prices by 45%.
“The potential large-scale disruption on health equity is immense as people in underserved communities are left to cope with fewer resources,” said Dr. Robert Biernbaum, D.O., Chief Medical Officer for WellNow Urgent Care.
“Excellus is making a decision that will create more underserved areas and cost New York State taxpayers more for Medicaid,” said Biernbaum.
Without WellNow in-network, Excellus subscribers will either pay out-of-pocket costs to use WellNow or Excellus will pay higher costs for urgent care services delivered in hospital emergency departments and hospital-owned urgent care centers. Some of those higher costs for Excellus subscribers are passed on to the state Medicaid program.
Medicaid provides coverage for health care services for millions of New York’s children, veterans, pregnant women, people with disabilities and seniors. Last year, WellNow Urgent Care Centers delivered high quality care for nearly 200,000 Upstate visits which were covered by Medicaid.
Ironically, Excellus is poised to spend more of its money and more Medicaid money in 2024 to cover services in hospital emergency departments and hospital-owned urgent care centers instead of at WellNow centers.
“It just doesn’t have to end this way,” said Dr. John Radford, founder of WellNow Urgent Care. “Excellus is using its strong market position to pressure WellNow into an unfavorable agreement.”
“In Western New York, where Excellus operates as Univera with less market dominance, they acknowledge WellNow as an urgent care and pay a fair rate. However, in Central New York, where Excellus has a larger market share, they present conflicting information, treating WellNow like primary care. Adding to the confusion, Excellus pays many hospital-owned urgent care centers in Central New York much more than what WellNow is asking under our existing contract in the Buffalo area,” said Radford.
“It’s quite simple – if Excellus pays us in Central New York what they pay us in Western New York, we will stay in network. Otherwise, we have no choice but to go out of network. At this point one must wonder based on their unwillingness to provide an offer of any merit and their slow responses, as these negotiations started nine months ago, if they have any interest in keeping us in network. Ultimately, I have concerns about Excellus’s commitment to healthcare access – it feels like they’re putting profits over the people of New York,” said Radford.
About WellNow Urgent Care®
WellNow Urgent Care is one of the fastest-growing providers of urgent medical care, virtual care, occupational health services and clinical research in the United States. Opened in 2012, the independent healthcare practices WellNow supports operate more than 200 centers across New York, Illinois, Indiana, Ohio, Michigan, Pennsylvania and Wisconsin. More information about WellNow Urgent Care’s services, hours and locations can be found at WellNow.com.
SOURCE WellNow Urgent Care
