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$1.50Vol. 148

No. 275 ©2017

ASHEVILLE - Understanding howmuch your health insurance will pay forwhat care from which provider is hardenough under normal circumstances.

The end Thursday of a contract be-tween Blue Cross Blue Shield of NorthCarolina and Mission Health that deter-mines how much the insurer pays themedical system for care adds yet an-other level of complexity.

The dispute between the two will dis-rupt relationships between physiciansand patients across Western North Caro-lina in coming days and weeks.

Over the longer term, when, howand whether the argument is settledwill have a major impact on how muchWNC employers and residents pay forhealth insurance and significantly in-fluence the finances of the region’slargest private employer and largesthealth care provider.

Following are answers to commonquestions about the dispute.

Question: How will this affect me?Answer: People insured by compa-

nies besides Blue Cross NC or who haveno insurance will see no change. Thesame is true for those insured by BlueCross NC who get their health care fromproviders that Mission does not own.

However, Mission has 12,000 employ-ees, about a fifth of physicians practic-ing in WNC work for the system and ithas seven hospitals in the region. BlueCross NC insures about 260,000 moun-tain residents. So, the relationship be-tween the two affects a lot of people.

People insured by Blue Cross NCcan still get care from Mission and the

The MissionHealth-BlueCross NCdisputeexplainedMARK BARRETTMBARRETT@CITIZEN-TIMES.COM

See HEALTH, Page 4A

Welcome home for Blue Ridge Honor Flight

Asheville Regional Airport was filled with people welcoming back the Blue Ridge Honor Flight on Saturday. The World War II, Korean War, andVietnam War veterans spent the day visiting memorials in Washington, D.C. PHOTOS BY ANGELA WILHELM/AWILHELM@CITIZEN-TIMES.COM

Wyatt Ausley, a Korean War veteran, is welcomed back to Asheville Regional Airport Saturdayafter participating in the Blue Ridge Honor Flight.

Lyle Bryson wipes his eyes as he walksthrough the airport.

WASHINGTON - Steve Bannon andother Trump-aligned conservatives arefeeling empowered by Roy Moore’s Sen-ate primary win in Alabama, upsettingthe White House’s favored candidate.And now they’re planning to try it againin other GOP races.

Flush with victory, Bannon and hisBreitbart news outlet as well as otherspinoff groups — those who want tofight the “establishment GOP” — plan

to dig up dirt on other GOP incumbentswho they feel might betray Trump’sagenda, and try to replace them in 2018Senate races.

“Bannon is plotting a strategy tolaunch an all-out-assault on the Repub-lican establishment,” said Andrew Su-rabian, a political strategist whoworked under Bannon at the WhiteHouse and now is a senior adviser to apro-Trump advocacy group. “I thinkit’s fair to say that if you’re tied to (Sen-ate Majority Leader) Mitch McCon-nell, any of his henchmen in the con-

sulting class or were a Never-Trumperduring the campaign, you’re not safefrom a primary challenge.”

On their list: Republican senators inArizona, Nevada, Mississippi, and annow open seat in Tennessee followingSen. Bob Corker’s announcement thathe would not seek re-election in 2018.Arizona Sen. Jeff Flake and NevadaSen. Dean Heller are considered thetwo most vulnerable Republican can-didates. Flake, in particular, has be-come a target because of his strongcriticism of the president.

Bannon was a senior adviser to Presi-dent Trump, but left in August and wentback to lead Breitbart, an ultra-conser-vative news website.

Bannon’s Breitbart going towar against GOP incumbentsELIZA COLLINSUSA TODAY

See WAR, Page 4A

PAGE 4A || MONDAY, OCTOBER 2, 2017 || ASHEVILLE CITIZEN-TIMES

AN-CAR0012392-01

Local Annual Meeting Notice

For members of SSC, Inc. Asheville Service

& Hendersonville Agronomy Plant

Tuesday, October 17, 2017

Dinner: 6:00p.m. / Business meeting: 7:00 p.m.

SSC, Inc. Asheville Service

464 Riverside Drive Asheville, NC 28804

Agenda includes annual elections and management reports.

By order of the Board of Directors

Brandon Wilson, President

doctors who work for it, but they may have to paymore. Until a new contract is signed, “out-of-network”rates will apply for Blue Cross NC policyholders whenthey get care from Mission providers. That typicallymeans policyholders will pay higher co-payments andface higher deductibles. Details vary by policy.

Q: What do I do if I have a Blue Cross NC insuranceand I have a heart attack?

A: Go to the emergency room right away and don’tworry about your insurance. Emergency room care isalways considered “in network,” so your share of thecost will be the same whether you go to a Mission hos-pital or a competitor.

Q: My doctor works for Mission or I need to havea procedure done at a Mission hospital. What aremy options?

A: If you are not insured by Blue Cross NC, every-thing stays the same.

If you have Blue Cross NC insurance, you canswitch to another physician or hospital in the BlueCross NC network not owned by Mission to continue topay in-network rates for your care.

You may be able to switch to another insurer. Mis-sion has agreements with Aetna and Cigna and otherinsurance companies. However, if you get insurancethrough your job, your ability to change insurers willdepend on what options your employer offers. Also,Blue Cross NC is the only company offering health in-surance via the Affordable Care Act in WNC.

You can continue to see your current doctor or con-tinue with plans for the procedure. That means you aresubject to paying higher out-of-network rates, al-though you can take advantage of a discount plan Mis-sion is offering those insured by Blue Cross NC.

Mission said in August it will give “a generous,prompt payment discount after taking into account thepatient’s personal financial responsibility.” To get thediscount, patients must send Mission the reimburse-ment check they get from Blue Cross NC and the ac-companying explanation of benefits — a statementfrom an insurer saying how much they paid and forwhat — within 10 days.

Q: I want to switch doctors or have my surgerydone somewhere else. Do other health care provid-ers have enough room to take care of me?

A: It depends on where you live and may involvesome extra travel.

Park Ridge Health, based in Fletcher, says many ofits physicians in Buncombe County are accepting newpatients, and Hendersonville-based Pardee UNCHealth Care says its physician practices and otherhealth care facilities also expect to treat new patients.Blue Cross NC says there is generally enough capacityin the regional health care system to accommodate pa-tients looking for new providers.

There are exceptions. Three-quarters of the physi-cians based in McDowell County work for Mission andall but one of the doctors based in Graham County do. Itis unlikely that the remaining doctors could handle theload if all of Mission’s patients switched providers.There may be other areas with similar problems.

There are some procedures and specialties forwhich Mission is the only provider in the region or em-ploys the vast number of providers. A Mission officialestimated that only a handful of cardiologists in WNCwork for anyone other than Mission.

State rules limit how far afield an insurer can requirea patient to go to get care. Blue Cross NC says it is work-ing with patients who need help locating providers. Insome cases, notably many pregnant women and cancerpatients, it says its customers will be able to continue see-ing their current providers without paying more.

Q: What are Blue Cross NC and Mission arguingabout?

A: At issue are the rates at which Blue Cross NCpays Mission for care that Mission gives people withBlue Cross NC insurance.

Blue Cross NC says its customers are demandingthat it slow the rise of insurance and health care costs.It says Mission should accept the offer of no increasein reimbursement for the first year of a contract thatwould probably run two or three years as 40 or so of thestate’s 110 hospitals have done.

Mission says the amounts it pays for drugs, medicaldevices, labor and other things it must buy keep goingup and it has already made its operations much moreefficient in recent years. It says it must get a rate in-crease to protect its long-term future because a higherpercentage of its patients are covered by Medicareand Medicaid — which provide reimbursements thatdo not cover the entire cost of care — than at othercomparable large health systems in the state.

Neither side has discussed specifics of their offersin contract negotiations, except for Blue Cross NC’sstatement that is offering no increase for the first year.

Q: If Mission agrees to no rate increase, does thatmean my insurance rates won’t go up?

A: No. A Blue Cross NC official said last week thatother costs it covers continue to rise and that the agingpopulation means people need more care, so its rateswould continue to rise.

Q: Why haven’t they worked this out already?A: It is difficult to know all of the reasons several

months of confidential negotiations did not yield anagreement. What is clear is that they stopped whenMission gave Blue Cross NC a notice of termination ofthe existing contract July 5.

Mission said that if it had not taken that step, thecontract would require it to keep providing care at cur-rent rates indefinitely, something it says it cannot af-ford to do. Blue Cross NC says it will not negotiate withMission or any other provider after it has received atermination notice.

Blue Cross NC says once it receives such a notice, ithas to focus on getting patients connected to new phy-sicians and continuing negotiations would interferewith that process. Mission says there is no reason thetwo sides could not keep talking after it gave notice,and one of its officials called Blue Cross NC’s policy ofno talks “childish.”

Q: What are the prospects for an agreementnow?

A: Blue Cross NC says it is willing to negotiate withMission once the existing contract expires Thursday.Mission says it wants to talk, too. We don’t know whenor whether that will happen.

Even if negotiations resume right away, it will prob-ably take some time before Mission would be part ofBlue Cross NC’s network again.

Dr. Ron Paulus, president and CEO at Mission, pre-dicted recently that it would probably be next year be-fore the two sides can work out a new contract.

Mark Werner, head of network management forBlue Cross NC, said it would take a few weeks to re-establish reimbursement arrangements once a con-tract is in place.

More informationParties involved in the Blue Cross NC/Mission

Health dispute have set up websites and other meansto get their side of the story to the public and to helppeople make alternative arrangements to get care.

» Information from Blue Cross NC is available viawww.bcbsnc.com/missionhealth or by calling 1-800-446-8053. Those insured by Blue Cross NC can also callthe number on the back of their insurance card.

» Mission has set up a website with information onthe dispute, www.standwithmission.org, and a tele-phone number people can call with questions: 828-417-0480.

HealthContinued from Page 1A Share your event at least two weeks in advance online at events.citi-

zen-times.com. Click on “Add your event” to submit details.

TodayBingo: 2-3 p.m., Senior Opportunity Center, 36 Grove St.,

Asheville. Open to seniors and older adults. 75 cents a card.Monday & Wednesday yoga: Jack’s Mountain Preserve &

Golf Course, 1001 Golf Course Road, Old Fort. Beginner/intro-ductor 9:30 a.m., Vinyasa flow at 11 a.m. $12, $50 for five classes,$90 for 10 classes.

Pumpkin Patch: To Oct. 31, Groce United Methodist, 954Tunnel Road, Asheville. 10 a.m.-7 p.m. Monday -Saturday and12:30-7 p.m. Sunday.

TuesdayMen’s soccer: Brevard College vs. Maryville:2-4 p.m. at

Brevard College. http://www.brevard.edu/.Parkinson’s support group: 10 a.m.-noon, Groce United

Methodist, 954 Tunnel Road, Asheville. Members and specialistsoffer strategies and techniques to better manage the disease.Join us on Facebook: Parkinson’s Support Group AVL.

Pig Pickin’ at West Asheville Tailgate Market: 5-8 p.m.,Grace Baptist Church, 718 Haywood Road. $15 per plate. Vege-tarian and gluten-free free options available. Also music andgames. http://www.westashevilletailgatemarket.com/events.

Wednesday“Making Culinary & Medicinal Ghee” workshop:7-9:30 p.m.,Vil-lagers, 278 Haywood Road, Asheville. Ghee is an ancient methodof transforming grass fed butter into a nourishing butter oil whichdoesn’t need to be refrigerated, can tolerate high cooking heat,and is lactose and casein free. $20. https://forvillagers.com/collections/classes/products/09-27-17-making-culinary-medicinal-ghee-with-marion-hearth-7-9-30pm.

“Social Media for Business” seminar: 6-9 p.m., A-B TechEnka Campus, 1459 Sand Hill Road, Small Business Center, room2046, Candler. Social media is a great way for small businesses toget themselves noticed and to drive business. Free. Register athttp://conta.cc/2rBalEW.

Blood profile testing:8:30-10 a.m. Wednesdays, Opportu-nity House, 1411 Asheville Highway, Hendersonville. No ap-pointment needed. For a complete list of tests and pricing, visitwww.opportunityhouse.org and click on newsletter.

Miss Malaprop’s Story Time: 10 a.m. Wednesdays, Mala-prop’s Bookstore/Cafe, 55 Haywood St., Asheville. Recommend-ed for ages 2-8. http://www.malaprops.com.

Biltmore Industries history tour:1 p.m. Wednesday-Sat-urday through December, Grovewood Village, 111 GrovewoodRoad, Asheville. Includes a visit to historic Dye House. Free butdonations appreciated.

Join my personal group of esoteric knowledge that willhopefully help you gain your hopes, wishes, help you knowyourself. Includes discussion of astronomy, astrology, holy texts,science, clairvoyance. Call Daniel at 864-347-1243.

Beginning Tai Chi class:9-10:30 a.m., Ox Creek CommunityCenter, 346 Ox Creek Road, Weaverville. Offered by Taoist TaiChi Society (taoist.org). First class is free.

Beginning Tai Chi class: 9:30-11 a.m., Asheville TrainingCenter at Town and Mountain Realty Building, 261 AshelandAve. www.taoist.org. First class is free.

Brevard College volleyball vs. Agnes-Scott: 6-7:30 p.m.at Brevard College. http://www.brevard.edu/.

ThursdayContemporary Line Dance class:1-2 p.m. Thursdays, Senior

Opportunity Center, 36 Grove St., Asheville. $5. Join any time.Slow Flow Yoga: 2:30-3:30 p.m., Senior Opportunity Cen-

ter, 36 Grove St., Asheville. Adapted for all ages and abilities.Bring your own mat or borrow one of ours.

Thursday Beach Night: 7-9:30 p.m., American Legion Post77, 216 4th Ave. W., Hendersonville. $5. Beach music and Caroli-na Shag with a DJ. Large wooden dance floor, bar and grill.

Meet author Mary Ann Claud: 5-7 p.m., Upstairs Art-space, 49 S. Trade St., Tryon. “Blue Ridge Pilgrimage” is a compi-lation of short columns written for Hendersonville Times-Newsnewspaper during 1980s-90s. Book takes readers on a jauntthrough out-of-the-way places and subjects of southern BlueRidge and foothills that are still fresh today.

“Convert Your Lawn to a Pollinator Patch” workshop:6:30-8:30 p.m., Villagers, 278 Haywood Road, Asheville. $0-$15 sliding scale.https://forvillagers.com/collections/classes/products/10-05-17-bee-the-change-convert-your-lawn-to-a-pollinator-patch-6-30-8-30pm.

Fermentation Show & Tell: 6-7:30 p.m., French Broad FoodCo-op community room, upstairs, 90 Biltmore Ave., Asheville. $10suggested donation. Bring your fermentation projects and stories.http://organicgrowersschool.org/events/home-grown-revolution/.

Live Boundless-A Different Kind of “Chair-ity” Banquet:6-9:30 p.m., Highland Brewing Company, 12 Old Charlotte Highway,Asheville. $50, reserved table of eight $375. Madeline Delp, the 2017Ms. Wheelchair USA and the Live Boundless organization presentfood, laughter and inspiration. Cocktail hour, silent auction, Italianbanquet. http://www.highlandbrewing.com/TastingRoom.htm.

COMMUNITY CALENDAR

One Republican who passes the pro-Trump test isNorth Carolina Rep. Mark Meadows, the chairman ofthe hardline House Freedom Caucus. Meadows en-dorsed Moore and recorded a robocall for him. “TheD.C. establishment is working overtime to keep JudgeMoore out of the Senate because he’ll put principleover politics,” Meadows says on the call.

Meadows’ deputy chief of staff, Wayne King, tooktime off and went down to Alabama to work at the highlevels of Moore’s campaign in the final week.

King was pictured with Breitbart’s Matt Boyle,Moore, Bannon, Surabian and Bannon ally Dan Fleutteafter Moore’s win Tuesday.

When USA TODAY asked Meadows what messageMoore’s victory sent to McConnell, he responded: “Themessage is you better start putting real bills on thepresident’s desk and if you don’t most people couldcare less about it.”

“It certainly would encourage more than discour-age” primaries against incumbents, Meadows said.

Breitbart staff see themselves as soldiers in abattle between the political class and averageAmericans and is ready to deploy their troops todig up any dirt on their opponents, according tosomeone who works closely with Bannon, who

spoke on condition of anonymity to describe theiraims. The person singled out Mississippi Sen. Rog-er Wicker as a target.

Anti-establishment favorite Mississippi state Sen.Chris McDaniel, an insurgent candidate who ran un-successfully to unseat Sen. Thad Cochran in 2014, isconsidering running against Wicker.

Wicker’s office did not immediately respond to re-quest for comment.

Bannon is also looking for anti-establishment Re-publican candidates to run for Senate in both Utah andNebraska. Both states are represented by Republicansin the Senate.

Eric Beach, co-chairman of the Great America Al-liance, an advocacy group that supports Trump’sagenda, told USA TODAY his organization spent“close to $200,000” to bolster Moore’s campaign.Beach is still solidifying their list but looking closelyat putting money into races in Arizona, Tennesseeand Nevada.

Moore, a former Alabama chief justice who wassuspended from the job twice, won the RepublicanSenate primary last Tuesday by 12 percentage points.He was running against Sen. Luther Strange, who wasappointed to the seat after Jeff Sessions was made at-torney general. Strange had the backing of PresidentTrump and the majority leader.

Even though Trump backed his opponent, Mooreran on a pro-Trump platform and Alabama voterssaid that Trump’s support made little difference intheir decision.

WarContinued from Page 1A

ASHEVILLE - Madeline Delp gradu-ated from UNC Asheville in May 2017with a degree in foreign language and aconcentration in management. Sheused those entrepreneurial skills tofound the nonprofit Live Boundless,which funds educational projects forthose with disabilities.

Along the way she won the title of MsNorth Carolina Wheelchair and then wascrowned Ms. Wheelchair USA in July.

Delp grew up in Western North Car-olina and wanted her first fundraisingevent to be in Asheville. Dubbed a“Chair-ity Banquet,” the event will be6-9:30 p.m. Oct. 5 at Highland BrewingCo., 12 Old Charlotte Highway. Admis-

sion is $50; tickets are available ateventbrite.com. (Search for “chair-itybanquet” in Asheville.)

“I love my home and there is no betterplace to start my journey than here,”Delp said. “What a fun place to host theevent at Highland Brewing Companywith the all the food donated by Carrab-ba’s Italian Grill.”

Delp’s vision is to film a video seriesthat educates wheelchair users on how toadapt to each area of life, hoping to inspire“people from all backgrounds [to believe]that no matter what their disability maybe, they too have the strength to thrive,and do anything they dream,” according toapress statement. Film production has be-gun, the group said.

“Madeline’s energy to do the right

thing by helping others inspires me tohelp her in any way I can,” said board ofdirectors chair Cindy Clarke, of the UNCAsheville Family Business Forum.

One of Delp’s professors at UNCAsheville, Susan Clark Muntean, in theDepartment of Management and Ac-countancy, added, “Her story, vision andpassion is infectious. She has a resonat-ing, national story with amazing visionfor her goals to help others.”

Delp often travels around the countryto speak, motivating others on how to over-come their physical challenges and to livea healthy and vibrant life. She has workedon several film projects, including thetelevised special “To Walk Again.“ Tolearn more, find the event and the Ms.Wheelchair USA 2017 pages on Facebook.

UNCA grad, Ms. Wheelchair USA, starts WNC nonprofit

Madeline Delp is Ms. Wheelchair USA.BLAIRE JOHNSON/COURTESY OF MADELINE DELP

Special to the Citizen-Times