With health insurance for hundreds of Shawano County residents at stake, representatives of ThedaCare health system and insurer Network Health met Thursday to try salvaging a 5-year-old partnership.
No deal was reported following the meeting, and ThedaCare President and CEO Dean Gruner said later the insurance company’s representatives were not willing to commit to an extension.
“We are very surprised and very disappointed,” Gruner said.
Network Health spokeswoman Jessica Fischer disputed that version of events, saying that talks broke down because of ThedaCare’s unwillingness to make a deal.
“Both parties walked away thinking the same thing about the other,” Fischer said. “That’s unfortunate.”
Both sides talked about continuing the discussion at some later date, although it was not clear how or when that would occur.
The situation has become increasingly anxious for health care consumers since ThedaCare announced that it was dropping Network Health coverage effective this coming summer because of a disagreement over the insurer’s reimbursement rates.
Because ThedaCare has become the dominant health care provider in Shawano, the issue affects residents in this area more disproportionately than in other parts of Wisconsin.
An estimated 3,700 people in Shawano County have health insurance through Network Health, most of them senior citizens who rely on the company to administer Medicare benefits. The Menasha-based insurer also serves employees at several local businesses and other workplaces.
ThedaCare, based in Appleton, celebrated the grand opening in September of a new $50 million hospital in Shawano, known at ThedaCare Medical Center-Shawano, which replaced the now-shuttered Shawano Medical Center.
The health care provider announced in mid-December that it would stop accepting Network Health insurance, effective July 31. The change would force area consumers to use ThedaCare without insurance, find new insurance, or seek out new doctors and providers who accept Network Health.
After ThedaCare’s announcement stirred angst among consumers, the two sides agreed to Thursday’s meeting to discuss extending their partnership, at least through 2016.
Gruner said the meeting lasted only about 10 minutes, largely because the Network Health representatives announced they were not prepared to discuss an extension. Gruner said ThedaCare was ready to accept an extension through 2016 without any change in the existing terms.
“We know that a number of people are facing uncertainty and are concerned about this,” he said.
Network Health officials offered unspecified assurances that the insurance company would get back in touch with ThedaCare later, Gruner said.
“That is not at all what we expected,” he said.
Fischer said Network Health officials offered to discuss an extension through 2016, and they presented a proposed deal. Fischer would not disclose details of the proposal, but she said ThedaCare representatives balked.
“We were there willing to have a conversation,” she said, adding in a prepared statement: “We are still in discussions with ThedaCare, working to come to an agreement as quickly as possible.”
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