Mercy to end its contract with Anthem BCBS in January, affecting 2.1 million in Missouri
More than 2 million Missourians may no longer be covered if they seek care at one of the state's largest health systems, which could affect patients in the Ozarks.
Mercy announced Sept. 10 that it will end its contracts with Anthem Blue Cross Blue Shield at the end of the year unless an agreement is reached. Those contracts include include all commercial, Medicare Advantage, Affordable Care Act marketplace, managed Medicaid plan Healthy Blue and HealthLink, which falls under the Anthem BCBS umbrella.
In a press release, Mercy said ending the contracts is an effort to "remove much of the red tape" when it comes to navigating Anthem's system. Mercy also said that Anthem BCBS has not kept pace with inflation when it comes to reimbursing them, despite the fact that "managed care companies are reaping enormous profits."
Emily Snooks, spokesperson for Anthem, said in a statement that Anthem would continue to try to reach an agreement.
"Mercy has informed us that if we do not agree to their drastic price demands, they will leave our health plans starting January 1, 2025. Over the next two years, Mercy wants to increase the prices they charge our members and employers by five times the current inflation rate," Snooks said. "Mercy has also demanded contract language that would keep specialty medications unnecessarily expensive when lower cost options are available. Anthem has offered reasonable payment increases in excess of the consumer price index for each of the next two years and we continue working hard to reach an agreement."
Mercy stated that Anthem reported a 24.12% increase in year-over-year net income and a 24.29% increase in its year-over-year net profit margin in June 2024.
“The cost of providing actual care for patients has risen significantly due to inflation, but Anthem has not kept pace with those rising costs when it comes to reimbursing us for the care we provide to our communities,” said Thompson. “It’s unreasonable for the insurer to increase its premiums to patients and employers and increase its profits while expecting those of us providing health care directly to patients daily to bear the brunt of the higher cost for providing that care.”
More: Trying to find a primary care provider in the Ozarks? Here are some resources
"Hundreds of thousands of Mercy patients" are on Anthem BCBS plans, according to Thompson. Patients on Anthem BCBS plans will be able to receive care at Mercy through Jan. 1, 2025. Mercy's retail pharmacy locations will continue to serve Anthem BCBS patients.
"We will continue to negotiate in good faith with Anthem in hopes of avoiding any disruption to our patients at the end of the year — particularly those patients in need of prolonged, coordinated care," Thompson said in a statement. "However, 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.”
Mercy encourages patients to share their concerns with Anthem by calling the number on the back of their health insurance cards or by calling Anthem 1-800-331-1476.
This article originally appeared on Springfield News-Leader: Missouri's Mercy health system ending Anthem insurance contract
