State of South Dakota, SDSU react to healthcare change

Sanford made the announcement in August that the organization would no longer be part of the DAKOTACARE network as of Jan. 1, 2017. 

State officials and state employees continue to react to this announcement and lack of information about what happens next.

According to Laurie Gill, commissioner for the Bureau for Human Resources, Sanford had been part of DAKOTACARE, an organization that provides health plans and services, for years. 

“An important message to all those people that are state employees, which include the staff of SDSU, the important message to them is right now there are no immediate changes,” Gill said. “… People that are currently enrolled in the state of South Dakota Health Plan can keep using their current providers and all of the services they have been used to at this moment.”

Sanford will no longer be part of the network at the beginning of 2017. 

Jesse Tischer, executive vice president of Sanford Health Network, said Sanford’s exit from the network was due to unequal representation of the two health systems. 

Sanford had been part of DAKOTACARE for about 30 years prior to leaving the plan after Avera bought DAKOTACARE in 2015.

Tischer said Sanford and Avera underwent negotiations throughout the summer to try and maintain a balance of power in regard to health plan networks.

“The negotiation back and forth throughout the summer of 2016 ended essentially with Avera denying Sanford the same opportunity that they already have through the DAKOTACARE product,” Tischer said.

One of Sanford’s proposed solutions during the negotiations was to have Avera take part in the Sanford health plan to provide clients with variety of healthcare options, but this proposal was denied. 

However, Tischer believes a solution will be available.

“Sanford and the state of South Dakota are actively working on a solution that members of the state’s insurance plan will have full access to Sanford health providers,” he said. 

According to Gill, the Bureau for Human Resources is in discussion with other health systems and networks. As of right now, there are no immediate announcements.

The issue hits home at South Dakota State University where full-time faculty and staff have insurance through the state. Individuals employed by the university and other state-affiliated organizations will no longer be able to go to Sanford providers once the change takes effect.

Meredith Redlin, president of faculty senate and professor, said the faculty have received “so little information,” and that it has been hard for them to determine what the impact will be. Redlin and other employees are waiting to hear updates from Human Resources.

“There’s certainly extra services in Sioux Falls that a lot of people use I know, and many of those are Sanford provisions, but as far as what the ramifications will be, we just don’t know I’m afraid,” Redlin said.

When Redlin first heard the news of this change, she thought it was “odd,” because there was a “strong emphasis” on Sanford before they withdrew from the network.

Faculty have approached her with this topic, but she thinks the conversation will begin once there is more information.

“I think people are waiting for more information and once they see those ramifications … then I’m sure we’ll hear and have a lot to say,” Redlin said. “But a lack of information makes it difficult to have a profitable discussion.”

She hopes that the all parties influenced by this change will be notified by October so they can make decisions regarding their insurance.

Other areas of campus have also had to react to this announcement.

According to Shawn Humboldt, assistant director of admissions and member of the professional staff advisory council, there hasn’t been discussion among the council members at this point.

Gill plans t okeed SD employees informed about the situation. 

“The main thing is that we know the healthcare market in South Dakota is evolving quickly, and our South Dakota state employee health plan continues to work through those changes,” Gill said, “and we will keep our members informed at new information becomes available.”