ROCHESTER, NY (WROC) WellNow Urgent Care announced that it plans to end its business relationship with Excellus BlueCross BlueShield by early next year if the company does not pay “fair rates.”
According to a statement sent by WellNow, it is not viable for WellNow to continue doing business with Excellus due to Excellus’ inability to commit to reasonable rates. It was alleged that Excellus’ rates for WellNow patients had decreased despite increases in rates for insured members.
“Excellus has received approval from the New York Department of Financial Services to increase its premiums almost every year. By our calculations, this represents an increase of more than 8% in premiums each year for their customers since 2017,” said WellNow President Sam Meites. “Yet they are unwilling to commit to reasonable rate increases that would help pay the dedicated healthcare professionals who have proudly worked to meet New York’s urgent care needs.
WellNow says many areas of upstate New York struggle with limited access to health care, also known as “health care deserts.” The company added that seven WellNow facilities were closed due to Excellus’ pricing.
“As we have failed to get Excellus to negotiate since 2016, reimbursement rates have fallen 35 percent, while inflation has skyrocketed,” said Dr. Robert Biernbaum, WellNow’s chief marketing officer. “Insurance company executives like to promote their nonprofit status and talk about the claims they have paid. »
WellNow states on its website that it will not turn away patients, but this means that, if the relationship ends, it will stop accepting Excellus insurance until they start paying providers fairly.
News 8 WROC has reached out to Excellus BlueCross BlueShield for comment on this announcement and will update this story as more details are revealed.
Additionally, Citizen Action of New York announced it would hold a rally against Excellus, alleging that the company refuses to treat its members.
Stay with News 8 WROC as we continue to update this developing story.
Full statement from WellNow Chief Medical Officer Dr. Robert Biernbaum:
Excellus reveals its fundamental misunderstanding of urgent care by calling WellNow Urgent Care centers primary care. Urgent Care Centers like WellNow bridge the gap between primary care physicians and emergency rooms by providing communities with high-quality, affordable and convenient health care options. Nationally, urgent care centers are estimated to prevent about 24.5 million emergency room visits per year, saving insurance companies like Excellus a lot of money if one considers that the average cost of an emergency visit is $1,646, while the average cost of an urgent care visit is only $171.
WellNow Urgent Care was founded in Western New York to help communities bridge the growing gap between urgent care needs and diminishing emergency room capacity across New York. York, particularly in underserved rural and urban communities. Rural hospital closures have hit communities hard, and WellNow has expanded to more than 70 care centers throughout Upstate New York, employing more than 2,500 people.
Studies show that urgent care centers like WellNow likely save millions in hospital emergency rooms by giving people alternatives for lesser illnesses and injuries, according to the National Institutes of Health. Urgent care goes far beyond primary care with more advanced procedures such as treating lacerations, fractures and performing x-rays to provide rural communities with a continuum of care. However, the truth is that without better rates offered by insurers like Excellus, there is a very real threat to the care provided by urgent care centers throughout New York State. Unfortunately, seven Wellnow urgent care centers in New York had to close this year due to Excellus’ inadequate pricing.
Because we have failed to convince Excellus to negotiate since 2016, reimbursement rates have fallen by 35 percent, while inflation has skyrocketed. Insurance executives like to tout their nonprofit status and talk about the claims they’ve paid. Public records reveal Excellus collected $6.6 billion in bonuses in 2022 and increased its bonuses 45% since 2016. Records show millions of dollars in excess profits in 2022 and compensation for its top four executives exceeded $6 million. Pretty good for a local non-profit.
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