Grand Canyon Times

The contract between BlueCross BlueShield of Arizona (AZ Blue) and Phoenix Children’s Hospital has expired, resulting in the hospital no longer being an in-network provider for AZ Blue patients. This change, effective from October 31, 2024, will increase costs for those seeking care at the hospital.

AZ Blue released a statement saying, “With Phoenix Children’s deciding to leave the network effective October 31, 2024, our priority is our members and their children who need care.” Dr. Cara Christ, AZ Blue's Chief Medical Officer, noted that negotiations stalled over a proposed $50 million raise amounting to a 10% increase over three years.

Phoenix Children's responded with their own statement: “BlueCross BlueShield is no longer an in-network provider with Phoenix Children’s and we’ve prepared this page on our website to encourage patient families to seek continuity of care and review what plans are in our network.”

The expiration of the contract has raised concerns among families relying on the hospital's services. Shelle Harman from Glendale expressed her frustration: “We know we’re getting the best care around here and for them to not come to an agreement is a slap in the face.” Her son Braxton receives extensive medical care through Phoenix Children’s.

Harman mentioned potential out-of-state travel as an option due to increased costs: “Braxton and I would have to travel out of state to go to whatever doctors we can find,” she said.

Dr. Daniel Derksen from the University of Arizona's Arizona Center for Rural Health believes an agreement may still be possible, citing past negotiations between PCH and Aetna which took two months after their lapse in 2023.

Phoenix Children's criticized AZ Blue's practices in their statement: "BlueCross BlueShield denies more than 10% of claims submitted by Phoenix Children’s." They further claimed that AZ Blue left discussions early while spreading misinformation.

In contrast, AZ Blue questioned Phoenix Children's decision-making process. "We’re baffled. Phoenix Children’s Just Turned Down an $80 Million Raise," they stated.

While current treatments and scheduled surgeries remain covered under existing agreements at Phoenix Children’s, patients must now consider alternative options or face higher costs for new services outside emergencies.

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