Goldsboro hospital discharged from Blue Cross network

Effective Thursday, anyone covered through the state's largest insurer will have to pay out-of-network rates for all care at Wayne Memorial aside from emergency treatment. Patients with Blue Cross Medicare Advantage, including Blue Cross secondary or supplemental plans, also aren't affected by the hospital's out-of-network status.

Blue Cross Vice President of Network Management Lisa Cade said the company has negotiated with Wayne Memorial for 18 months to try to rein in costs, and the ongoing stalemate left them with no option but to sever ties with the hospital.

Wayne Memorial's prices trend 85 percent higher than comparable hospitals, the insurer has said, and outpatient services, which account for the bulk of the hospital’s billings, had increased 121 percent over the last 10 years.

"We regret that the hospital’s executives and Board chose to reject our proposal rather than agreeing to reasonable terms that would have helped Wayne County families afford their care," Cade said in a statement. "At the end of the day, Wayne Memorial’s best offer demanded that our customers pay guaranteed annual increases higher than any other hospital in the state on prices for outpatient services that are already far in excess of the statewide average."

Wayne Memorial President and Chief Executive Bill Paugh said the hospital made concessions on each of Blue Cross' demands, but "it was never enough."

“This is not the outcome we wanted, but accepting Blue Cross’ offer meant reductions in our services and an impact to our staff," Paugh said in a statement. "That’s not in the best interest of our patients or our community. As a responsible community hospital, we simply can’t accept a contract that would have such a negative impact.”

Hospital officials said they would work to keep most patients' out-of-pocket costs at in-network levels through the end of March.

“We don’t want to put our patients in the middle of this situation,” hospital chairman Dr. Christopher Griffin said in a statement. “They shouldn’t be forced to pay higher out-of-pocket costs, drive out of the area to receive care or delay necessary treatment out of concern for costs. While this isn’t a long-term solution and it is going to be a challenging process, we will do our best to protect our patients from any unnecessary burdens."

Blue Cross will inform its customers of in-network options for their hospital services, Cade said.