Mercy, Anthem Blue Cross Blue shield strike new deal
Mercy and Anthem Blue Cross Blue Shield announced early Wednesday they reached a new contract agreement, which means more than 2 million Missourians insured by Anthem will continue to have medical care with Mercy providers fully covered.
A short press release gave little details, only stating that the “new multi-year agreement” will give Anthem members “uninterrupted in-network access to Mercy doctors and care sites.”
The agreement includes all Missourians covered by Anthem’s employer-based Medicare Advantage, the Affordable Act Marketplace and Healthy Blue Medicaid plans.
The announcement by one of the St. Louis region’s largest health systems and one of the state’s largest health insurers comes nearly three months after Mercy revealed it was ending its contracts with Anthem by Jan. 1 unless an agreement was reached.
People are also reading…
Employers and insurance purchasers are now breathing a sigh of relief after spending the past several weeks working to alleviate fears among employees with Mercy providers.
David Cook, president of United Food and Commercial Workers Local 655 and co-chair of the union’s health and welfare fund, said his office had been flooded with daily calls.
Cook’s office administers health benefits to about 8,000 area grocery workers, and over half of their claims go through the Mercy network.
“People don’t have confidence in their insurance. They don’t have confidence in a lot of things around health care. But I tell you one thing, they trust and confide in their doctor,” he said. “When you tell them they can’t go to that person they trust, it’s not good for their mental well-being.”
When Mercy officials revealed that contracts with Anthem could be ending, they warned: “Patients and employers considering which health plans to purchase for 2025 should consider whether Mercy, the largest health system in the state, will be in the plan they purchase.”
Still, Cook had remained optimistic the two sides would work out a deal.
“Anthem is clearly the biggest insurance carrier in the metropolitan area, and Mercy is right at the biggest hospital network,” Cook said. “They cannot survive, in my opinion, without each other long-term. They have to have each other.”
In a press release, Mercy officials complained of barriers to getting procedures approved in a timely manner. They also claimed Anthem’s reimbursements have not kept pace with rising costs despite reaping higher profits.
Anthem officials accused Mercy of wanting to increase prices for commercial members and employers by five times the current inflation rate and of using misleading profit data. Anthem also said it pays 92% of claims within 15 days, and 98% within 30.
Sheldon Weisgrau, vice president of health policy and advocacy for the non-profit Missouri Foundation for Health, said consolidation among health systems and insurance companies has given them more leveraging power while leaving consumers with fewer choices.
“All of that consolation drives up costs, does not impact quality in a positive way and is a real burden in access to care,” he said, “and that seems to be what we are seeing here with this dispute between Mercy and Anthem.”
Laurel Pickering, who works with employers as president of the St. Louis Area Business Health Coalition, said she is encouraging employers to consider contracting with more than just one health insurance provider for their employees.
“One of things that I’m trying to do at the St. Louis Business Health Coalition is expose employers to the idea that there are good reasons to offer more than one option,” she said, “and we have some new options in our market, some that are coming and some that have already been here.”
The business news you need
Get the latest local business news delivered FREE to your inbox weekly.
No Byline Policy
Editorial Guidelines
Corrections Policy
Source