Mercy Physician Association terminates contract with Blue Cross Blue Shield, forcing patients to switch providers

A physicians group tied to one of McHenry County's largest health care providers will no longer work with some Blue Cross Blue Shield insurance plans, it decided this summer, forcing people such as county employee Wendy Wesolek, who is being medically monitored after surviving cancer twice, to find new physicians during less-than-ideal times.

Mercy Physician Association notified the insurance provider June 30 that it would terminate its medical group contract effective Jan. 1, Blue Cross Blue Shield of Illinois spokeswoman Colleen Miller said.

Blue Cross is the largest insurer in Illinois, according to its website. The termination affects Blue Cross members in the HMO Illinois, BlueAdvantage HMO and Blue Precision HMO networks, Miller said.

Mercy Physician Association works with Mercyhealth, a regional health system with seven hospitals, including one in Harvard and another planned for Crystal Lake. The hospitals and other care facilities will remain in-network for all Blue Cross Blue Shield members, Miller said.

"We understand this change may cause concern for our members," Miller said in an email.

For Wesolek, the decision by the Mercyhealth doctors comes after they helped her twice beat uterine cancer that was initially diagnosed in 2017, and came back in 2018. She had two surgeries and endured radiation treatments and chemotherapy until April of last year.

She has been undergoing routine CT scans and blood analysis and has to continue doing so for at least another two years, she said, and is nervous about switching health care providers during the monitoring.

"These people saved my life twice. It’s now going to require me to see new doctors in the middle of a cancer protocol, of things I have to deal with," Wesolek said. "They’ll be people who don’t know anything about me."

The situation is frustrating, she said, "and I feel like they care more about the money than the health of their patients."

It is unknown how the decision by the group of doctors for Mercyhealth to quit accepting the Blue Cross insurance plans will impact the medical care provider's bottom line.

A spokeswoman for the system, Trish Reed, declined to comment on that aspect, but she said in a statement that Mercyhealth is continuing to work on design plans for its Crystal Lake hospital development project.

"We know patients on this plan have built a valuable relationship with their care team and we want to continue to provide them care moving forward," Mercyhealth Vice President Patrick Cranley said through the spokesperson.

He suggested that patients who want to continue seeing their Mercyhealth doctor after Dec. 31 could select a new insurance plan that includes Mercyhealth as a preferred provider for next year.

Neither Blue Cross nor Mercyhealth disclosed points of tension expressed by the physicians association regarding its contract with the insurer or during negotiations on a possible new deal after the Northwest Herald inquired.

"Blue Cross and Blue Shield of Illinois is committed to our members, our group customers, as well as the communities we serve," Miller said. "Our mission is to continue to deliver access to quality, cost-effective health care in Illinois and to increase health equity for all. That includes creating and designing networks that balance access and affordability of care."

Blue Cross notified its members impacted by Mercy Physician Association’s decision to leave its HMO networks in September and they were given instructions on how to select another in-network provider group in their area, Miller said.

Members who do not select a new medical group by Nov. 1 will be assigned to one and notified, Miller said.