Mercy Health providers considered 'out of network' to patients with Anthem
CINCINNATI — Mercy Health providers and facilities are now considered out of network for people who have Anthem Blue Cross Blue Shield Medicaid insurance after months of ongoing negotiations failed to reach an agreement, a spokesperson for Mercy Health said in a press release.
The change went into effect July 1, but Mercy Health said it will still serve Anthem patients in Ohio through July 31. The healthcare company said it wants to make this transition easier on patients and give them time to change insurance plans to "ensure long-term access to the doctors and facilities they know and trust."
During the month of July, all Anthem Ohio Managed Medicaid patients should call the Ohio Office of Medicaid at 1-800-324-8680 to initiate a just cause transfer to an alternative managed medicaid plan to ensure they can retain long-term access to their Mercy Health facilities and providers, the company said.
Mercy Health said it is still contracted with all Managed Medicaid plans in Ohio, with the exception of Anthem, and will continue to serve patients under new health plans.
"We want to continue negotiating to ensure access to care is available when you need it at a Mercy Health location that is convenient for you," the company said. "We encourage Anthem to do what is right for its Ohio Managed Medicaid members today and in the future."
According to Mercy Health, all patients will continue to have access to Mercy Health hospitals when emergency treatment is required, regardless of the network status with Anthem.
Mercy Health isn't the first healthcare company in the region to struggle with its relationship with Anthem. Back in March The Christ Hospital Health Network announced it reached an agreement with Anthem after various negotiations, but coverage was tenuous at first. A Christ Hospital spokesperson previously said Anthem was hard to negotiate with.
According to the announcement, the new agreement will build on Anthem and Christ's long partnership to "deliver care that will improve the health of those we collectively serve."
If an agreement between the two was not reached prior to April 1, patients could have been paying out of pocket.
Anthem previously provided WCPO with the following statement:
“The Christ Hospital Health Network has informed us of their intent to leave Anthem’s care provider network unless we agree to allow them to drastically increase prices for the people and businesses we serve. Cost increases of this magnitude — more than double the current inflation rate for hospital services — are unacceptable, especially when Greater Cincinnati families and businesses are already struggling with a difficult economy. To be clear, these increases would directly impact consumers through dramatically higher out of pocket costs and indirectly through higher insurance premiums. In response, Anthem has offered Christ Hospital responsible increases that are in line with those recently accepted by other area health systems and include opportunities for millions in additional value-based payments for meeting industry standard measures for quality care. We will continue to work in good faith to reach an agreement that maintains our members’ access to quality, affordable care at Christ Hospital and their employed physicians.”
WCPO has reached out to Anthem for comment on the newly failed negotiations with Mercy Health but has not yet heard back.
Source: WCPO 9 Cincinnati
