Aug 17, 2023
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The facts about Anthem’s contract negotiations with Bon Secours Mercy Health
Bon Secours Mercy Health (BSMH) has notified Anthem that they will no longer accept Anthem Medicaid coverage effective July 1, 2023, and Medicare Advantage coverage effective October 1, 2023, unless we agree to dramatically higher costs for those in our employer-sponsored and ACA health plans. Bon Secours Mercy Health is leveraging these vulnerable populations to drive higher costs for employers and their employees. As trusted partners, we want to be sure you understand the background of this situation and that you’re prepared with the facts to answer potential questions from your clients and peers in the community.
Timeline of events
In January 2022, a fair and mutually agreed-upon contract went into effect providing Anthem’s employer-based and ACA health plan members with in-network access to BSMH hospitals and physicians until January 1, 2025. This contract included reasonable annual payment increases to account for the rising cost of healthcare services.
In late 2022, BSMH informed Anthem that it was seeking a double-digit payment rate increase, in addition to the increases already agreed to, for services to our employer-based and ACA plan members, even though a contract is in place until January 2025. The payment increases that BSMH is seeking are triple the current hospital inflation rate and would create unacceptable cost increases for those insured through ACA and employer-sponsored health plans.
Using vulnerable populations to drive up costs for employers and individuals
Because a binding contract is in place for our employer-sponsored and ACA plan members, BSMH notified Anthem earlier this year that it will no longer accept Anthem members in our Medicaid and Medicare Advantage plans. BSMH is not asking for increases in Medicaid payments; they are leveraging a highly vulnerable population of health plan members to gain additional revenue from employers and individuals.
Our commitment to our members
Anthem’s first focus is our members. Because Medicaid and Medicare members are particularly sensitive to healthcare disruption, we are helping minimize any disruption of care by helping them transition to in-network care providers.
We are also helping members who are currently receiving care from BSMH for certain types of care understand their options for continuing care with their current provider.
We will continue working in good faith to resolve this situation and minimize any disruption of care for these vulnerable members. Our goal, as always, is to provide our members access to high-quality, affordable healthcare.
We appreciate your partnership and encourage you to visit anthem.com/bsm for more information.