Residents with Anthem Blue Cross Blue Shield insurance could soon find themselves out of network at a local hospital.
According to a press release, Anthem has paid Memorial Hospital and Health Care Center and its employed physicians “significantly less than other providers in the region” for years.
And after three years of discussions between Memorial and the insurance titan, a mutually agreed upon contract has not yet been reached.
“Memorial Hospital proudly serves as one of the region’s lowest cost providers of care with the highest quality outcomes,” said Kyle Bennett, Memorial president and CEO, in a prepared statement. “But Anthem’s low payments are just not sustainable. We are looking to be reimbursed at rates comparable with other providers in the region — nothing more, nothing less.”
He continued: “We must fix our contract with fair, competitive rates from Anthem so we can secure our future and continue serving as our region’s trusted source for high-quality care.”
The contract between the two entities will expire on Nov. 27. Memorial patients who have Anthem will not experience any changes in their coverage until that time, if a new contract is not signed.
“Contract discussions are a standard and routine part of what we do to ensure our members have access to affordable healthcare from a large network of providers,” an Anthem representative told the Herald. “Talks with Memorial Hospital and Health Care Center are still in the early stages. We have made some progress, and both sides have committed to meet on a regular basis to continue negotiating. Yet, at this point, we do have concerns about the significant increases they are requesting.”
According to the Anthem representative, a recent national study by the Rand Corporation found that hospital costs are higher in Indiana than in 25 states they surveyed, adding that “we have an obligation that we take very seriously to negotiate provider contracts that will protect our members from further significant increases in the cost of healthcare.”
In a Friday interview, Bennett didn’t provide an exact number of the hospital’s patients who use Anthem, but he did say it is “substantial.” If an agreement is not reached, “residents will be forced to drive long distances to seek in-network care that should otherwise be accessible to them locally,” a hospital press release reads.
Bennett said the two groups are working together in good faith to negotiate a deal that will allow Memorial to continue to provide affordable, quality, safe and excellent care to patients.
“In order to make real progress towards a new agreement, Memorial Hospital needs Anthem to engage in meaningful discussions, and recognize the impact inadequate reimbursement has on health care in Dubois and surrounding counties,” the press release reads. “Memorial Hospital and Health Care Center plays a vital role in the health and wellbeing of residents in an eight-county service area.”
Date: September 10, 2019
Source: Dubois County Herald