Mercy Health and Anthem Blue Cross Blue Shield Medicaid Reach Impasse in Negotiations
CINCINNATI – Mercy Health providers and facilities are no longer considered in-network for individuals with Anthem Blue Cross Blue Shield Medicaid insurance. After months of negotiations failed to reach an agreement, Mercy Health announced in a press release that the change went into effect on July 1.
Despite this change, Mercy Health stated that it will continue to serve Anthem patients in Ohio until July 31. The healthcare company aims to make the transition easier for patients by giving them time to change their insurance plans and ensure long-term access to the doctors and facilities they trust.
To assist with this process, Mercy Health advises all Anthem Ohio Managed Medicaid patients to contact the Ohio Office of Medicaid at 1-800-324-8680 during the month of July. Initiation of a just cause transfer to an alternative managed Medicaid plan will help ensure the retention of long-term access to Mercy Health facilities and providers.
Although Mercy Health remains contracted with all Managed Medicaid plans in Ohio, with the exception of Anthem, the company strives to continue negotiations. Their goal is to ensure that access to care is available when needed at a convenient Mercy Health location for patients. Mercy Health urges Anthem to prioritize the needs of its Ohio Managed Medicaid members both now and in the future.
Notably, emergency treatment at Mercy Health hospitals will still be accessible to all patients, regardless of their network status with Anthem.
This isn’t the first time a healthcare company in the region has faced challenges with Anthem. In March, The Christ Hospital Health Network encountered difficulties during negotiations, but ultimately reached an agreement. Coverage, however, initially remained uncertain. Anthem was regarded as a tough negotiator during that period, according to a spokesperson from The Christ Hospital.
Previously, Anthem had provided a statement to WCPO regarding negotiations with The Christ Hospital, stating that the hospital network intended to leave Anthem’s care provider network unless they agreed to significantly increase prices for their services. Anthem argued that such cost increases were unacceptable, given the economic challenges already faced by families and businesses in Greater Cincinnati. The insurance provider offered responsible increases that aligned with recent agreements with other area health systems, which included additional value-based payments for meeting quality care measures.
As of now, no comment has been received from Anthem in response to the failed negotiations with Mercy Health.
Viewers can watch WCPO 9 News at 7PM for live updates on this ongoing issue.