Prime Healthcare recently sought to reassure many of its Illinois patients after they received a notice that its hospitals and physicians may no longer be in their network.
The health system, which as of some recent dealmaking runs eight hospitals in the state, published a notice last week confirming that it has not yet inked a new contract with Blue Cross and Blue Shield of Illinois (BCBSIL). Should no deal be reached, the system would leave the BCBSIL network on June 1.
“Unfortunately, BCBSIL’s letter may create unnecessary concern for patients while negotiations are still ongoing,” the statement reads. “Our goal is to reach an agreement that protects patient access while ensuring hospitals can continue to provide high-quality care in the communities we serve.”
Prime’s statement stressed that its hospitals and physicians are currently in network, and that no appointments or procedures should be rebooked. The system, referencing state and federal laws such as the No Surprises Act, also said it follows requirements protecting patients against unexpected out-of-network charges and requiring the provision of emergency services regardless of insurance status.
“We value the care Prime provides to our members and communities and are working closely with them to come to a mutual agreement,” Erika Callahan, a spokesperson for Blue Cross and Blue Shield of Illinois, told the Chicago Tribune in a statement Thursday. “If an agreement is not reached by June 1, 2026, Prime Healthcare facilities, hospitals and health care professionals will no longer be in-network.”
BCBSIL did not immediately respond to Fierce Healthcare’s request for comment.
Prime Healthcare is a for-profit health system that runs 54 hospitals, 21 of which are under the purview of its non-profit Prime Healthcare Foundation. It employs over 60,000 people across 15 states and sees about 3 million patients annually, according to its website.
The organization entered Illinois a year ago when it purchased eight hospitals from Ascension Illinois for more than $370 million (a ninth hospital that was initially included in the transaction was shut down) and promised to invest $250 million into upgrades and improvements in the coming years. Prime has caught flack in the months since for its changes to those hospitals’ service lines, which local leaders said was in conflict with its purchase agreement. The system responded that the facilities were losing $200 million annually and that changes were necessary to make operations more sustainable.
“Prime Healthcare remains hopeful that BCBSIL will work collaboratively with us to finalize an agreement that prioritizes patients and preserves access to care across Illinois,” the system’s statement reads.
Contract disputes have made headlines over the past year as commercial insurers and health systems alike navigate their rising expenses. The dustups that have gone public haven’t always just been talk—some systems like Johns Hopkins Medicine and Lehigh Valley Health Network ultimately chose to let their contracts lapse.
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