When a hospital, health system, or physician's practice loses a contract with a single insurance provider, it is usually seen as a problem for only those directly affected. However, the ripple effects go further, impacting not only those individual patients but employers, other insurers, and the entire healthcare system, raising costs for everyone. 

As we saw with BayCare, contract renegotiations almost resulted in a swath of patients in Florida losing access to healthcare services; shortly before the deadline on 9/30/25 an agreement was made. However, this still left over 5,500 senior citizens scrambling to find new doctors or insurers as they suddenly became out of network. Insurers negotiate rates to keep healthcare services accessible, however out of network providers are no longer subject to the contracted rates nor PPO and other network discounts. These higher out of pocket costs often result in patients delaying their care or avoiding care altogether. 

While not necessarily applicable to the private outpatient physician practice, when patients seek care from now out of network systems, the insurers appear to bare the increased costs of out of network care. Though, they will not do this without "spreading the love". These increased costs are passed on to all members through higher premiums for everyone. 

For those that decide to remain with their current insurer and seek care from the remaining in-network facilities, sudden demand surges strain staff and resources, resulting in long wait times and lower quality care. Of note, current wait times for a neurologist in the Bay Area average greater than a month, often spanning up to 90 days or greater. This creates an imbalance that lowers quality of care and forces individual providers to raise their own prices in order to manage the pressure. 

The bottom line is simple: when providers and insurers cannot agree on terms, the fallout affects more than just those two parties... It disrupts access to care, increases the costs across the board, and contributes to the ever-rising healthcare spending in this country. A focus on patient-centered outcomes, transparency, and good faith negotiations are key to keeping healthcare affordable for everyone.