CINCINNATI – Mercy Health providers and facilities are now considered to be locked out of the network for people who have Medicaid insurance from Anthem Blue Cross Blue Shield after months of ongoing negotiations failed to result in an agreement, a Mercy Health spokesman said in a press release.
The change went into effect July 1, but Mercy Health said it will continue serving anthem patients in Ohio through July 31. The healthcare company said it wants to make this transition easier for patients and give them time to change their insurance plans to “have long-term long-term access to the doctors and facilities they know and trust.”
In July, all Anthem Ohio Managed Medicaid patients should call the Ohio Office of Medicaid at 1-800-324-8680 to initiate a fair transition to an alternative Managed Medicaid plan to ensure they have long-term access to their Medicaid program. Plan retained by Mercy Health facilities and providers, the company said.
Mercy Health said it remains affiliated with all of Ohio’s managed Medicaid plans, with the exception of Anthem, and will continue to serve patients under new health insurance plans.
“We wish to continue negotiating to ensure access to medical care is available at all times, 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 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 that it had reached an agreement with Anthem after various negotiations, but the coverage was initially tenuous. A spokesman for Christ Hospital previously said it was difficult to negotiate with Anthem.
According to the announcement, the new agreement will build on Anthem and Christ’s long partnership to “deliver care services that improve the health of those we collectively serve.”
If an agreement hadn’t been reached between the two before April 1, patients might have had to pay out of pocket.
Anthem previously provided the following statement to WCPO:
“Christ Hospital Health Network has informed us of their intention to exit Anthem’s care services network unless we agree that they drastically increase the 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 families and businesses in the Cincinnati area are already grappling with a tough economy. To put it bluntly, these increases would impact consumers directly through dramatically higher ownership costs and indirectly through higher insurance premiums. In response, Anthem has offered Christ Hospital responsible increases consistent with those recently accepted by other healthcare systems in the region, and include opportunities for additional value-based payments amounting to millions of dollars for meeting industry standard measures to provide quality care. We will continue to work in good faith to reach an agreement that will ensure our members’ access to quality, affordable care at Christ Hospital and its staff physicians.”
WCPO has reached out to Anthem for comment on the recently failed negotiations with Mercy Health, but has not yet received a response.
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