Why did Alaska Native Medical Center (ANMC) choose to terminate their contract with Premera Blue Cross Blue Shield of Alaska?
ANMC chose to terminate their contract after discussions with us about solving their use of Guardian Flight, an Alaska air ambulance service, which has resulted in a significant increase in costs for such services. Those costs ultimately impact our members in the form of higher premiums.
Guardian’s current pricing practices mean that air ambulance transports previously billed at $49,000 are now billed at close to $150,000. We feel strongly that our members deserve more affordable options, given the availability of other air ambulance providers in Alaska to provide the same timely, high quality service at a significantly lower cost. We have asked ANMC to work with us to deliver such important services to our members at a more affordable price; however, ANMC does not seem to share that concern about costs for our customers.
What’s the impact to Premera members using ANMC?
We do not expect any additional out-of-pocket costs for Premera ‘s Alaska Native and American Indian members seeking care at ANMC because of the facility’s choice to leave the network.
ANMC has informed us that Alaska Native and American Indian beneficiaries who receive care at ANMC will not be required to pay a deductible or co-payment, regardless of ANMC’s status as a provider in Premera’s network.
Why is ANMC using Guardian when other options are available for air ambulance service?
ANMC informed us that they have an exclusive contract with Guardian for air ambulance services. ANMC is contractually obligated to use Guardian when transporting any of its patients -- including Premera members -- to or from Anchorage and the other Regional Tribal Hospitals. In exchange, ANMC was able to negotiate favorable rates with Guardian. ANMC has further informed us that these lower rates have resulted in significant savings for ANMC.
However, the favorable rates that ANMC enjoys in return for utilizing Guardian for all of its patients – including Premera members – do not apply to Premera members who are transported by Guardian to and from ANMC facilities. Thus, the ANMC-Guardian arrangement significantly increases costs for our customers in the form of higher premiums, since Guardian has refused to contract with Premera at market competitive rates.
What’s the next step?
We will be happy to work with ANMC in the future should they demonstrate interest in controlling costs for our customers by substantively addressing the Guardian issue.
Ultimately, however, our concern on this issue comes down to costs for our customers. ANMC’s continued choice to use an exceptionally high-cost, air ambulance provider in Guardian is not an acceptable outcome. We are committed to our work to control such costs, as we have done across Alaska in working to mitigate the impact of Guardian’s pricing practices on our customers.