After months of negotiations, Anthem Blue Cross and Blue Shield and Parkview Health appear to have failed to have reached a contract agreement, but did agree on the final day of their latest deadline to continue talking for two days.
Without an agreement, Parkview’s system would have been out of network for Anthem members’ health plans beginning July 29.
The existing contract will now expire at 11:59 p.m. July 30.
Parkview Health released the information in a statement the evening of July 28.
“We’ve made progress, but both sides felt it was important to take more time to try to work through our differences rather than allowing the contract to end tonight at midnight,” said Mike Packnett, president and CEO, Parkview Health. “We will continue our discussions in earnest, working to avoid significant disruptions for our patients and area employers.”
Tony Felts, Anthem spokesman, released a statement. “An independent analysis by the RAND Corporation last year revealed that Indiana has the highest hospital costs among the 25 states they studied. Anthem has a responsibility to address this issue and make healthcare more affordable for our customers and members. That’s why we continue to be focused on a new contract with Parkview Health — one that is fair and brings greater affordability to consumers in northeast Indiana. We have agreed to extend the current contract two days in hopes that the remaining issues can be resolved.
The current agreement pertains to all Parkview providers and facilities in Indiana. Parkview Physicians Group providers based in Ohio are not impacted and will remain in-network for Anthem members.
Patients with questions can call Parkview at 1-844-241-0032, 8 a.m.-5 p.m. Monday-Friday, or visit parkview.com/anthem for more information.
Parkview Health has kept patients informed through its website, www.parkview.com/about-us/anthem. It posted July 27 that it “remains engaged in discussions with Anthem of Indiana, communicating daily. We have continued to work toward a patient-centered solution and have presented Anthem with multiple options that will lower costs not only for patients, but also for employers. Our most recent proposal was submitted on Friday, July 24. Knowing the majority of Anthem patients in the region prefer Parkview hospitals and physicians, we want to ensure you have continued access to our high-quality care.”
Felts wrote in an email at 3:30 p.m. July 28, “This contract negotiation is about making healthcare more affordable for Anthem’s consumers in northeast Indiana. According to federal data, Indiana residents spend 4.4% more of their annual income on healthcare than the average American. That is why Anthem approached Parkview officials 10 months ago to begin conversations about a new contract that provides greater affordability.”
Without an agreement, those covered by Anthem/Blue Cross health plans who use Parkview doctors or facilities will be charged out-of-network prices, which are usually significantly more than in-network prices.
Anthem has listed three exceptions that will allow patients to continue at their current Parkview facility:
• Those in an ongoing course of treatment
• Those in their second or third trimester of pregnancy
• Those receiving care that’s already approved, or pre-authorized, by Anthem
Anthem sought earlier this year to end its contract with Parkview over what it felt were Parkview’s “unsustainable prices that have the potential to put healthcare out of reach for the average person.” However, because of the COVID-19 pandemic, the contract was extended 90 days until July 28.
Anthem has cited an independent study in 2019 by the RAND Corporation, a nonprofit research institute, that found that the costs Parkview charges private health plans, like Anthem, are nearly four times higher (395%) relative to the prices allowed by Medicare.
Parkview says 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.
Anthem has kept patients informed on its own website at anthem.com/ftwaynebusinesscoalition.
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