CommercialCoverageHigh impact
OHSU and Regence BlueCross BlueShield of Oregon renew network agreement
Regence BlueCross BlueShield of Oregon·OR·Network
Effective date
Jan 1, 2027
We identified it
Aug 28, 2026
Summary
OHSU and Regence BlueCross BlueShield of Oregon have renewed their network agreement, keeping OHSU facilities (OHSU Hospital, OHSU Doernbecher Children's Hospital, and Hillsboro Medical Center) in-network for Regence commercial members. However, this agreement explicitly excludes Medicare Advantage and Individual (Marketplace) plans for 2027, which will require billing teams to verify plan type before processing claims.
Action Required
By December 31, 2026: Billing team must update insurance verification procedures to confirm that OHSU facilities remain in-network ONLY for Regence commercial plans starting January 1, 2027. Remove OHSU from in-network provider lists for Regence Medicare Advantage and Regence Individual (ACA Marketplace) plans effective 2027. Update claim submission system to route OHSU claims to out-of-network processing for MA and Marketplace plans. Train front desk and revenue cycle staff to identify plan type during verification and flag Medicare Advantage or Marketplace members for special handling. Failure to properly classify plans will result in incorrect reimbursement and patient balance issues.