When Blue Cross Blue Shield of Tennessee (BCBST) announced late last month that it would not offer individual plans through the Marketplace exchange in the state’s three largest metro areas next year, that meant Vanderbilt University Medical Center—Tennessee’s top-ranked hospital—would become an out-of-network provider for anyone insured under an exchange plan.
Vanderbilt confirmed recently that it would participate in individual plans only outside the Marketplace exchange in 2017, but would consider “viable opportunities” for expanding its participation in the exchange, should they become available, according to the Washington Examiner. The medical center will be in-network for plans offered by Aetna and Farm Bureau, which will not be sold through the exchange.
This year, individuals enrolled in an exchange plan have in-network access to Vanderbilt through just two BCBST networks (and no other insurers). Losing in-network access to Vanderbilt could prove costly for those who rely on the medical center’s specialized care capabilities.
BCBST will continue to offer individual plans through the exchange in 2017 in mostly rural parts of the state—with a 62 percent increase in premium rates and narrow networks, the Washington Examiner reported. Cigna and Humana will also participate in the exchange, but like BCBST, not statewide. The Washington Examiner noted that 73 of the state’s 95 counties will have just one insurer participating in the Marketplace exchange.