Mercy, Anthem reach new agreement

Thousands of Lincoln County residents can rest a bit easier when it comes to their health care.

On Wednesday, it was announced in a joint statement that Mercy and Blue Cross and Blue Shield in Missouri (Anthem), an insurance provider, have reached a new multi-year arrangement.

For many months, Anthem and Mercy tried to reach a new arrangement. But when negotiations stalled, Mercy announced its intent in September to end the agreement if a new contract was not reached by the end of year deadline. Dave Thompson, Mercy’s senior vice president of population health and president of contracted revenue previously told the Lincoln County Journal the main focus of negotiations boiled down to “low-cost, high-quality care.”

Previously, Thompson said via a press release that Anthem has a system that creates obstacles for patients trying to get proper care and makes it challenging to maneuver. With inflation increasing and the cost of care growing, Thompson said “Anthem has not kept pace with those rising costs when it comes to reimbursing us.”

“If you or a loved one have ever dealt with an insurance denial for care your doctor has recommended and felt was needed, that is what we’re talking about,” Thompson said in an email.

“Not only do those denials cause stress and anxiety for our patients and their loved ones during an already stressful time of a health crisis, but it adds administrative costs for the hospitals to work on behalf of the patient to appeal for the care that our clinicians have ordered.”

But Emily Snooks, director of public relations for Anthem said in a prior email response that they have “offered Mercy reasonable payment increases in excess of inflation for a multi-year period.” Further, she adds Mercy wanted to charge members and employers more than five times the present inflation rate.

If the two entities would not have reached an agreement then 18,673 county residents would have been put out of network come the new year according to Thompson. Snooks noted that 7,000 Anthem members that have recently used Mercy would have faced the same fate, considering that not all Anthem members use Mercy.

The new agreements allows for continued access and care for the following per a statement: Anthem members covered by Anthem employer-based, Medicare Advantage and Affordable Care Act Marketplace health plans in the state. In addition, Missouri Care, Inc — doing business as Healthy Blue — have come to an agreement for Healthy Blue Medicaid. Members with in-network Healthy Blue will continue on as well.

The details of the new contract have not been released. When contacted by the Lincoln County Journal, neither Mercy nor Anthem had further comment.