Aspirus and Blue Cross MN Contract Talks May Lead to 2026 Out-of-Network Status

Aspirus health facilities in Minnesota face potential out-of-network status with Blue Cross and Blue Shield of Minnesota (BCBSMN) if contract negotiations fail to produce a new agreement by the end of the year. The nonprofit health system cites inflationary pressures, Medicaid reimbursement cuts, and labor market challenges as key factors driving the need for higher payment rates. Aspirus St. Luke's notified patients that current reimbursements from BCBSMN do not cover the cost of care under the existing contract, which expires December 31, 2025.

BCBSMN manages the largest provider network in Minnesota, covering 97% of providers statewide, and negotiations for provider contracts typically conclude before renewal deadlines. The insurer states that reimbursement rates consider service types, provider specialties, efficiency, and health outcomes. BCBSMN claims that Aspirus has terminated the contract to seek significantly higher payments exceeding market standards while noting Aspirus' total cost of care is higher than the state average.

Aspirus assures patients that care access remains unchanged for now and expresses optimism for a fair agreement. However, failure to reach consensus would result in Aspirus' hospitals, clinics, and surgery centers becoming out-of-network for select BCBSMN commercial plans in 2026. BCBSMN commits to supporting affected members by coordinating care transitions and maintaining in-network access to Aspirus facilities through December 31, 2025.

Aspirus references independent analyses indicating its reimbursement rates are substantially lower than those paid to other providers in the market, calling the disparity unsustainable. Meanwhile, BCBSMN's rates for individual and small group health plans have risen over 11% from 2024 to 2025, with a proposed increase above 16% for 2026. Both parties continue negotiations with updates available through Aspirus' local access portal.

This pending contract dispute highlights the ongoing pressures on healthcare providers and insurers to balance reimbursement rates amid rising costs and regulatory challenges in Minnesota's health insurance market.