Original post: January 26, 2023; Updated: March 28, 2023
Premera Blue Cross and EvergreenHealth reached a new multi-year agreement, which ensures there is no disruption for Premera members who receive care at EvergreenHealth. The new contract allows members across all Premera lines of business, including commercial, individual and Medicare Advantage, to retain in-network access at EvergreenHealth, which has facilities throughout King and Snohomish counties.
Premera and EvergreenHealth began negotiations with the goal of reaching an agreement that ensures Premera-insured patients have access to affordable, quality healthcare. The new contract represents collaboration between the two organizations that provides stability and access to affordable care. It also focuses on improving the patient experience through value-based reimbursements. The goal of value-based care is to improve the quality of care provided to patients and bring more value to everyone involved in the total cost of healthcare. These goals are met by balancing quality, cost, and patient experience.
When Premera enters into any negotiations with a healthcare system, we do so on behalf of our customers. It is our role during these discussions to be an advocate for our customers’ dollars, which includes partnering with providers on practical solutions to drive down costs. We’re grateful for the patience of our customers as we worked hard with the team at EvergreenHealth to reach an agreement.
To find more information about providers in your network, you can use our Find a Doctor tool or call the phone number on the back of your member ID card.
What does this new contract mean for me? Does this mean I won’t need to find a new doctor or pay out-of-network prices?
Your access to medical care from EvergreenHealth will continue uninterrupted. You will retain in-network access at EvergreenHealth.
I changed my provider away from EvergreenHealth. Can I change back?
You can keep your new provider or change back to your EvergreenHealth provider. The choice is yours.
What if my health plan is from another Blue Cross Blue Shield plan, and not Premera?
Since Premera holds the contract with EvergreenHealth, this ensures other Blue Cross Blue Shield (BCBS) plans that offer BlueCard also retain in-network access. Many BCBS plans offer coverage through BlueCard, a nationwide network that uses the local BCBS health plan for access to in-network providers. You can tell if you have BlueCard coverage by looking for the small PPO suitcase icon on your member ID card.
What can you tell me about the terms of the contract?
While the specific terms of the contract are confidential, the new agreement represents collaboration between the two organizations that provides stability, access to affordable care, and the opportunity to improve patient outcomes through value-based reimbursements.
Why do providers terminate their contracts with health plans?
How do provider terminations affect member healthcare costs?
What does out-of-network and in-network care look like after a provider termination?
How can a hospital be in network but its providers are out of network?
