You May Not Be Able To Use Tufts Health at MetroWest Medical in 2015

If Tufts Health Plan and Tenet, a for-profit company that owns MetroWest Medical Center, can not come to an arrangement by tomorrow, Dec. 31, individuals and families with Tufts Health Plan will find the Framingham hospital as an out-of-network hospital, come 2015.

It also means inpatient, outpatient or ancillary services may result in higher out-of-pocket costs for users.

Tenet, based in Dallas, Texas, operated more than 75 hospitals in 10 states, with more than 100,000 employees.

“Tufts Health Plan pays our hospitals less than our competitors,” St. Vincent Hospital of Worcester and MetroWest Medical Center of Framingham/Natick wrote in a paid advertisement in Telegram & Gazette newspaper earlier this month.

The two are negotiating what Tufts will pay the Tenet for medical services at its hospitals in Massachusetts, which include MetroWest Medical Center in Framingham/Natick and St. Vincent Hospital in Worcester, when Tufts members use the hospitals.

Tenet wants Tufts to close the gap between what it pays Tenet’s hospitals and what it gives other hospitals in the state. Neither side has discussed a figure publicly.

Tufts Health Plan Medicare would not be affected, if an agreement is not reached.

Tufts notified policy holders about the situation. In the letter to subscribers, Tufts promised holders would not be denied adequate care should they no longer be able to go to Tenet’s hospitals in 2015.

Town of Framingham employees have Tufts Health Plan as one of its options.