Representatives for both Parkview Health and insurance company Anthem of Indiana said March 6 they are still negotiating to make a deal by April 29. If no agreement is approved by then, Anthem will terminate its contract with Parkview.
That means after that date those insured by Anthem who use Parkview doctors or facilities will be charged out-of-network prices, which are usually significantly more than in-network prices.
“As caregivers, nothing is more important than ensuring our friends and neighbors have access to the care they need, and we are still negotiating in good faith with Anthem to reach a solution that will protect patients’ access to Parkview providers and services,” Parkview said in a statement March 6.
Tony Felts of Anthem said the following in an email:
“The businesses and consumers Anthem serves in northeast Indiana have expressed their concerns about increases in the cost of healthcare, and we take those concerns very seriously as we work to negotiate a fair contract that protects affordability. We continue to negotiate in good faith with Parkview Health in an effort to reach a new contract before April 29 when the current contract expires. Both sides are communicating regularly. At this time there is no change in our network or in our members’ access to care from Parkview Health.”
Anthem members who are enrolled in Anthem PPO, HMO and POS benefit plans; Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect and Medicare Advantage plans would be affected.
If negotiations fail, Anthem members have the option of finding new health care providers and facilities that are still in Anthem’s network.
Both Anthem and Parkview have established pages on their respective websites outlining their positions. Anthem’s page is at anthem.com/ftwaynebusinesscoalition.
A statement on the webpage explains why Anthem is threatening to sever ties with Parkview:
“We are disappointed that Parkview has thus far demanded unsustainable prices that have the potential to put healthcare out of reach for the average person. An independent study in 2019 by the RAND Corporation, a nonprofit research institute, found that the costs Parkview charges private health plans, like Anthem, are already nearly four times higher (395%) relative to the prices allowed by Medicare. By refusing to reduce costs to a more reasonable amount, Parkview is placing an unfair burden on individual consumers and employers in the form of high copayments, deductibles, and premiums.”
Anthem goes on to say the RAND study “showed Indiana has the highest average hospital costs of the 25 states surveyed. The study showed that Parkview is the highest cost hospital system in Indiana by a wide margin ... Furthermore, their costs are 30 percent higher than the state average. For the benefit of our employer accounts and their employees, Anthem wants to renegotiate the current contract to provide a more reasonable level of reimbursement. At this time, Parkview has refused.”
Parkview has its own section on its website dealing with the current conflict. It can be found at parkview.com/about-us/anthem. The webpage says, in part, “Even though Anthem chose to terminate our contract, Parkview is committed to finding a patient-centered solution. We are focused on lowering costs for patients, plan to offer Anthem a solution to accomplish this goal and will continue working to protect our valued patients.”
Parkview also disputes the RAND report, saying it does not “provide an accurate picture of healthcare costs at Parkview Health or in the state of Indiana.”
Parkview asserts the data in the RAND study is extremely limited; Medicare rates are not an appropriate benchmark for commercial rates; the RAND study uses misleading data; and Indiana’s insurance premiums are below average compared with other studied states.