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Measuring the Impact of Multicare's Possible Exit From the Regence Network
The Board of Trusteees contracts with Regence to offer a PPO network for the Northwest Carpenters Health and Security Plan. PPO is short for "preferred provider organization," which is an independent company that negotiates discounted rates with providers across all healthcare specialties. The Trustees pay a fee to Regence to make those discounted fees available to Plan participants and dependents.
Presently, the doctors and facilities of MultiCare Health System are participating providers in the Regence PPO network. This is expected to change, however, because Multicare has informed Regence and affected patients that it will no longer participate in the Regence network beginning March 1, 2024. If MultiCare follows through with its decision, their withdrawal will affect doctors and facilities in the following Washington counties: King, Kitsap, Lewis, Pierce, Snohomish, Spokane, and Thurston. Two MultiCare facilities plan to remain in the Regence network: MultiCare Capital Medical Center in Olympia and MultiCare Yakima Memorial Hospital.
The Trustees believe it is important for participants and dependents to recognize the potential impact of this change on their out-of-pocket medical costs. The main reason for offering a PPO network is lower costs for patients when care is received from participating providers. If a patient continues to receive care from a provider who no longer participates in the network, charges for covered services and supplies will be paid at the out-of-network level. This will likely increase the patient's out-of-pocket expenses, in the following ways:
- Copayments for office visits will be higher with out-of-network providers. Those copayment amounts will not be applied to the Annual Out-of-Pocket Maximum.
- Coinsurance generally will be higher for services and supplies received from out-of-network providers. Out-of-network coinsurance amounts will not be applied to the Annual Out of Pocket Maximum.
- Out-of-network providers can bill patients for any amounts not reimbursed by the Plan. This practice is commonly called "balance billing."
The Northwest Carpenters Health and Security Plan allows participants and dependents to receive care from any licensed provider. Out-of-pocket costs will always be lower when care is received from a participating network provider. Refer to a Regence plan booklet for more information about the impact of provider choice on a patient's out-of-pocket expenses. Visit www.regence.com to search the online directory for network providers.
If MultiCare leaves the Regence network and you currently receive care from MultiCare providers, you may have the right to continue in-network treatment for a limited time. Please contact Regence to explore your options: (866) 240-9580.