Patients are the real victims of insurance network cuts | Opinion

What good are life changing treatments if patients are denied access to them?


(Photo: Thomas R Machnitzki/The Tennessee Lookout)

By Kristi Dunn

As someone well acquainted with our nation’s healthcare system, I can say that for all its complexities, it delivers groundbreaking, innovative treatments that are helping countless Americans overcome chronic illnesses and diseases like cancer, diabetes, and more.

But what good are these life changing treatments if patients are denied access to them?

The incredibly troubling trend of rural hospitals and providers shutting down due to a limited availability of funds is well documented and debated in our state. Those problems are being compounded by the trend of large insurance companies forcing providers out of network.

One of the most egregious examples is right here in my home state of Tennessee. Blue Cross Blue Shield of Tennessee (BCBST), one of the largest health insurance companies in the state, is threatening to cut the number of in-network providers for the nearly half a million customers that are enrolled in its service.

The unfortunate reality is hundreds of thousands of Tennesseans who have chronic illnesses will suffer because BCBST is trying to improve their bottom line through hardball contract negotiations with provider networks.

This is the latest in a long saga of profits driving insurance companies’ decisions even when it means prioritizing dollars over patients’ health. BCBST has cited increased costs as a rationale for its decision, but financially the company has thrived in recent years, recording a net income of well over a half a billion dollars last year, which marked a 46% increase from the business’s previous year.

Patients are ultimately paying the price and are sadly already feeling the impact. In 2022, BCBST removed Methodist Le Bonheur Healthcare from its network. In the days that followed, news surfaced of the negative effects the change was on Tennessee families that depended on Le Bonheur for care.

One mother whose daughter has cerebral palsy and other complex needs described the difficult position her family was now thrust into: “We’ve got to move and uproot my family, or I’ve got to change to one of these other insurances and start all over again.” Both options would be difficult for anyone, let alone a patient with unique circumstances that requires around the clock care.

This heartbreaking story is one of many, and sadly the number of similar stories like this across our state will only grow as BCBST continues making cuts to its network.

Whether it be losing access to the doctor they’ve trusted for years, or the dialysis treatment center they’ve relied on for life saving kidney treatment, patients with differing complex needs will see their healthcare access drastically reduced if Blue Cross continues down this path.

There is no “one-size-fits all” approach to healthcare — patients suffering from chronic illnesses require care that is tailored toward their specific needs. While a big insurance company’s ideal model is one in which networks are minimized so profits can soar, this model would have dire implications for a patient dealing with a unique form of cancer, or one who requires specific treatment for a chronic kidney disease.

Kristi Dunn is a mother, a healthcare worker, and an activist on the issues of public education and healthcare. She wrote this column for the Tennessee Lookout, a sibling site of the Pennsylvania Capital-Star, where it first appeared.

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Capital-Star Guest Contributor
Capital-Star Guest Contributor

The Pennsylvania Capital-Star welcomes opinion pieces from writers who share our goal of widening the conversation on how politics and public policy affects the day-to-day lives of people across the commonwealth.