Contract negotiations between Florida Blue and Cleveland Clinic Florida could affect whether some patients on the Treasure Coast maintain in-network access to care, according to statements from both organizations.
The discussions involve Cleveland Clinic Indian River Hospital, Cleveland Clinic Martin North Hospital, Cleveland Clinic Tradition Hospital and Cleveland Clinic Martin South Hospital.
A Florida Blue spokesperson said the insurer’s current contract “ensures our members will maintain in-network access to Cleveland Clinic Florida doctors, hospitals, and health teams through at least May 31, 2026,” despite what Cleveland Clinic has communicated, the spokesperson claims.
Cleveland Clinic stated that if an agreement is not reached, the health system “will no longer be in-network for Florida Blue members as early as March 1, 2026.”
Both sides say negotiations are ongoing. Cleveland Clinic said it has engaged in “good-faith discussions” with Florida Blue and that its goal is to remain in-network while protecting patient access to coordinated care. The organization also said it is working toward a resolution to avoid disruptions to coverage.
Frank Isele, president of Cleveland Clinic Indian River Hospital, said rising operational costs are a factor in negotiations.
“Over the years, there's much less margins that the insurance companies want to pay less. The cost of care goes up. All the headwinds and all the costs that are affecting health care now, from supply costs to provider shortages to staff shortages, the cost of operating a hospital, power costs, all that, everything is more expensive,” Isele said.
Florida Blue said it has made “reasonable offers” aligned with inflation and local market conditions and is seeking to balance support for hospital partners with protecting members from unsustainable cost increases, the spokesperson claims.
“Our hospitals and our health care providers have a responsibility to try to negotiate the best rate they possibly can for their financial sustainability. And so that's what's happening now,” Isele said. “This is happening all over the country, happens every day with all different insurance companies.”
Patients with employer-sponsored Florida Blue plans, Health Insurance Marketplace plans, Medicare Advantage and Federal Employee plans could be affected if an agreement is not reached, according to Cleveland Clinic. Patients with out-of-state Blue Cross and Blue Shield plans seeking care at Florida locations may also be impacted.
Florida Blue said that if negotiations fail, some members may qualify for Continuity of Care protections, which can allow pregnant patients, those receiving active treatment for serious or complex conditions, and patients recovering from surgery to continue seeing their providers at in-network rates for a period of time.
Cleveland Clinic similarly advised patients to explore continuity-of-care options through Florida Blue, noting that the insurer determines which services may continue to be covered.
Florida Blue said members would be notified of their options and supported through any transition if network changes occur. The insurer also noted that members have access to a network of hospitals, physicians and ancillary providers across the Treasure Coast and Palm Beach County for elective care, and that emergency care is always covered, even at out-of-network hospitals.
Cleveland Clinic also said emergency care would not be affected by the negotiations.
Isele said such contract disputes are common and often resolved.
“In all the years I've been doing this, all the different health care providers that I've worked with, 95% of the time these resolve because Florida Blue wants to maintain a relationship with Cleveland Clinic Florida. And of course, Cleveland Clinic Florida wants to maintain a relationship with Florida Blue,” he said.
The health system encouraged patients with appointments scheduled after March 1, 2026, to review their coverage and scheduling options, adding that representatives may contact patients to discuss whether appointments can be moved earlier.
Isele also emphasized the hospital’s role in the local health system.
“Cleveland Clinic, for our case, Indian River Hospital, they're the largest employer in our county. They provide care to more people than anyone else in our county. And so it's really important that those margins are there,” he said.
“Seventy percent of the folks that use our hospital have Medicare. We don't have a lot of business and industry in Indian River County. Some of the counties to the south that have Cleveland Clinic hospitals, they have a lot more industry. They have a lot more commercial payers. Our county is one of the more challenging to operate in. We have very little private insurance in our community,” Isele said.
Both organizations said they will continue providing updates as negotiations progress.