Provider Perspective

March 14, 2024

Interview with Dr. Karin Selva 

Senior Medical Director, Pediatric Subspecialties (Diabetes and Endocrinology, Nephrology Rheumatology, Pulmonary, Neurology) 
Medical Director, Randall Children’s Hospital Gender Care Center 

Karin Selva As a provider and health care advocate in this community, what are your concerns about the ongoing negotiations between Legacy Health and Regence?  
The families that we care for will be left stranded to find care for their children. In many of our pediatric subspecialties, wait times are very long. We see these patients between two and four times per year. If they are dropped and can’t see their specialty care provider for their scheduled visit, it may be months before that child will be seen as the wait list for transfer of care is often over six months at other locations. I worry that children will have serious gaps in care, which will exacerbate their chronic condition. They won’t know where to go when they have a serious issue or need their prescriptions refilled. As a result, they will be flooding our EDs – and those of the other hospitals in our community – because they have nowhere to go. 
Not to mention that we follow our kids for a long time – often from when they are very young until they graduate from high school – and see them multiple times a year – which results in very established, trusted relationships with them and their families. Losing that relationship will be a significant loss to both provider and patient family.  
We build a complete care team to support a child and their family; people often say they couldn’t get through it without their team. It’s truly a bonding experience and breaking that bond will cause great anxiety for these young patients and their families. They have gone through the scary part of receiving a diagnosis and we’ve worked closely with them to care for them and build their trust, often from a very early age. These long-standing relationships – involving the entire care team whom they rely on – are going to be severed for insurance reasons, which is very sad and will cause unnecessary stress on these children and their families.   
If an agreement is not reached, how will this affect Legacy patients who are Regence members? How will it impact you as a provider? 
One of my families was just asking me about this and has shared that they will change their insurance in order to continue to receive care from me. But until they do, they will be in a position to pay out-of-network. They have the means to do that if needed, but most families do not. I feel bad about that as it’s a financial burden that causes even greater stress and anxiety when caring for a chronically ill child. They shouldn’t get stuck with paying out of pocket for something their insurance has been and should be covering.  
What are you telling patients who have questions about this situation? 
I have a really hard time picturing that this could happen to so many people. I can’t believe Regence would really let this happen to their members, including children. If it does, it will really diminish my faith in the future of healthcare. 
I am hopeful that Regence will do the right thing – to provide coverage for these children and families without disruption. If we don’t come to an agreement, I will let families know we will be there to provide referrals to help ease the transition.  
If you could tell the head of Regence one thing, what would it be? 
Put yourself in this position and think about how this would affect your chronically ill child to not receive the care they need, when they need it. Imagine how disruptive this would be to you and your family and how damaging it could be to your child. You are putting children and families through unnecessary stress to even consider this, let alone if it comes to fruition. I urge you to use just a portion of your more than $215 million in profits to ensure Legacy can continue to provide the critical care your members need. 

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