Blue Cross Blue Shield of AZ cuts ties with one of Maricopa’s two OBGYNs

MomDoc, one of Arizona’s largest women’s healthcare providers, and one of Maricopa’s only two dedicated OBGYN providers, is breaking ties with Blue Cross Blue Shield of Arizona network starting next Monday.

The action follows more than two years of stalled contract negotiations, the provider said yesterday. The announcement affects patients across MomDoc’s 17 locations, including the Cobblestone Fiesta clinic on John Wayne Parkway, and comes as the state faces one of the nation’s most severe OBGYN shortages with rural counties even more severe.

The breakdown came over the reimbursement for medical professionals offered from BCBSAZ.

MomDoc CEO Nick Goodman said reimbursement rates from BCBSAZ have not kept pace with the rising cost of delivering care, and, in some cases, fall below Medicaid or AHCCCSrates.

“Arizona has 15.3% fewer doctors delivering babies than 10 years ago,” said Goodman in a statement. “MomDoc needs to continue partnering with plans that compensate properly so we can recruit high-quality OB doctors to the state. No longer can MomDoc afford to subsidize underpaying commercial plans.”

Goodman argues that Arizona’s commercial reimbursement rates remain tied to a years-old cost-of-living model, even as housing, labor and operating expenses have surged.

“Arizona is no longer a low-cost state to live or work in, yet commercial health plans continue to compensate OB doctors as if it was,” added Goodman.

Following the announcement, MomDoc took to its TikTok account to dispute a letter BCBSAZ sent to employer groups, which stated the provider “had no intent to negotiate.”

“False, false, false, false, false,” a MomDoc representative said in a TikTok video. “This decision follows over two years attempting to engage in meaningful discussions to secure fair and sustainable reimbursement rates.”

The provider said it sent a new proposal to BCBSAZ earlier this week.

“Per the request from Blue Cross Blue Shield, MomDoc sent a proposal on Monday,” another video stated. “We haven’t gotten a response yet, but we are hopeful.”

MomDoc urged patients to advocate on their own behalf.

“Talk to your employer group. Call Blue Cross Blue Shield. Let them know how important this is to you,” the representative said. “Your voice matters… This is going to help us as we continue this fight for what Arizona women deserve, which is quality healthcare.”

BCBSAZ told employers that MomDoc has “signaled no intent to negotiate” and has chosen to leave the AZ Blue network. In a private message, BCBSAZ told its MomDoc patients that pregnant patients, women with scheduled procedures and those undergoing active treatment will have up to 90 days of transitional coverage after that December cutoff.

“These are mostly employer plans, so this is impacting a lot of families in Maricopa,” MomDoc’s press ambassador, Sarah Bruner, told InMaricopa on Tuesday.

BCBSAZ did not immediately respond to a request for comment.

In another TikTok video, MomDoc certified nurse midwife Angie O’Donnell described a recent patient experience she said illustrates the severity of Arizona’s provider shortage.

Her patient needed a stat referral to a specialist due to a pregnancy complication, typically a three-to-five-day turnaround.

“When we called around to so many specialists, we still couldn’t get her in for over two weeks,” O’Donnell said, trying to find help in Phoenix. “It’s crazy to think about in a city with a population of almost 5 million people… This is happening right here.”

She said such delays, now common across the Valley, show the strain placed on OBGYN networks as recruitment falters.

“This is another huge symptom of the OB provider shortage we’ve been trying to bring to people’s attention so that families are having safe and healthy pregnancies,” O’Donnell said.

MomDoc said it will ensure continuity of care for existing BCBSAZ patients, including access to medical records and assistance in transitioning to new providers as required by regulation.

“Our patients are at the heart of every decision we make,” Goodman said. “We will continue to advocate for fair compensation that protects access to high-quality women’s healthcare in Arizona.”

An Arizona Center for Rural Health, county-level data shows just how few clinics are available for pregnant women. The study found Pinal County has about 1.0 OB/GYN physicians per 10,000 women, while Maricopa County had about 2.3 OB/GYN physicians per 10,000 women. 

This article was originally published on InMaricopa.com