Although contract negotiations between Valley Health System and Anthem Blue Cross and Blue Shield are ongoing, Valley Health officials say the two sides are at an impasse.
The current four-year contract between the two ends in January. According to Valley Health President and CEO Mark Nantz, the contract renews under the existing terms if the two parties do nothing and make no changes.
But Nantz said on Wednesday that negotiations are ongoing regarding rates, Valley Health’s rate of reimbursement and nuances in the contract language.
“If we do not want the contract to renew and we want to make sure Anthem stays at the table to get something done, we had to give notice that we’re not going to renew if we don’t get this worked out,” Nantz explained.
Valley Health is a regional health care provider and parent company of Winchester Medical Center and five other hospitals in the area. Anthem Blue Cross Blue Shield is one of the area’s largest health insurance providers.
Scott Golden, director of corporate communications for Anthem, confirmed the insurance company is continuing negotiations and is hopeful a deal can be reached, but acknowledged the two sides are still working through matters.
“We continue to actively negotiate with Valley Health in an effort to reach an agreement that would protect affordability for consumers and businesses,” Golden said. “While we would like to keep Valley Health in our care provider network, we cannot agree to the rate increases they are currently asking for, which would make health care costs in the Winchester area some of the highest in Virginia.”
The contract covers all of Valley Health’s facilities as well as all of Anthem’s products and services, according to Nantz.
Normally, Nantz said, there’s always a “fair bit” of negotiation between two sides in contracts such as this.Typically, contract negotiations remain private, but Nantz said Valley Health wanted to inform its patient base that if a new contract isn’t agreed upon, those with insurance through Anthem will need to prepare for Anthem being out of network.
If a contract isn’t agreed upon, the change won’t take effect until Jan. 1. In that case, Nantz said, Valley Health will set up infrastructure to help patients.
Chris Rucker, Valley Health’s vice president of strategic services, said not having Anthem in network would affect about 40,000 patients.
Nantz added that the current contract with Anthem accounts for about 20% of Valley Health’s business.
“We’re not going to allow the contract to just renew — that’s not acceptable. But we’re in good faith negotiating how we’d like to get this resolved before the end of the year in order to avoid any disruption to Anthem beneficiaries or our patients,” Nantz said. “I think we and Anthem want the same thing: their beneficiaries and our patients to have interrupted care. But I think both Anthem and us have come to realize that we may not be able to come to an agreement.”
Golden said Anthem will continue to work toward a new deal with Valley Health.
“We still have four months to reach an agreement that is in the best interest of health care consumers, and that is what we are committed to doing,” Golden said.
Should a deal not be reached, Nantz said Valley Health would communicate forthcoming changes to anyone who would be impacted.
Golden added that current Anthem customers are still able to see their Valley Health providers at this time in network.
Source: Winchester Star