We are working hard to reach a new agreement that preserves access to care, avoids disruptions and keeps costs down for our members, before our current agreement expires on October 31, 2025. We realize that East Tennessee Children’s Hospital (ETCH) is the preferred choice for health care services for many of you. We know that, if an agreement isn’t reached, this could limit your access to care at a critical time. Here’s what you need to know:
- As advocates for our members, we have a responsibility to provide access to quality care at the best possible prices. We cannot keep premiums affordable for our members if we’re paying significantly more to healthcare providers for the same care.
- Last year, we paid out a record $20.1 billion in claims on behalf of our members and Tennessee employers. Our customers are facing an affordability crisis, and we’re responding by making changes that will provide them with much-needed savings.
- These changes include improving the way we review claims before they’re paid, to make sure they accurately align with the services provided, adjusting payment policies for mid-level providers, and lowering lab and drug costs in the BlueCare program.
- We value ETCH’s role as an important part of the provider community throughout Tennessee. We respect the care their clinicians deliver and hope they’ll agree to reasonable terms that allow them to remain in our networks.
- Our current contract with ETCH extends through October 31, 2025 – so you won’t see any change or impact until November 1, 2025. However, we’re working hard now to try to reach an agreement before our contract ends.
- ETCH doesn’t offer any services that aren’t available through other in-network providers, including University of Tennessee Medical Center in Knoxville and the Children’s Hospital at Erlanger.
If our members have a true emergency, they should go to the closest emergency room, including those at ETCH facilities, even after October 31, 2025. Check out our FAQ page for additional information.
Please check back for additional updates.