Memorial Hospital UpdatesNovember 15, 2019
This site is intended to help explain the issues and to keep you appraised of the latest developments with Memorial Hospital and Health Care Center.
January 15, 2020
We're pleased to announce that the contract agreement with Memorial Hospital and Health Care Center has been finalized, and Anthem members can continue to access in-network health care benefits.
November 27, 2019
Memorial Hospital of Jasper agreement extended.
We're close to reaching an agreement to keep Memorial Hospital in Anthem’s plans. We've extended our current agreement until January 15, 2020, so Anthem members can continue to receive in-plan benefits while we work out a deal.
November 25, 2019
Anthem Blue Cross and Blue Shield continues to meet with Memorial Hospital and Health Care Center. Anthem has provided additional feedback on our best and final offer which was presented to Memorial on November 21. The final Anthem offer met Memorial more than half way on their top negotiation requests. It is our understanding that Memorial is meeting with their governing Board early this week to review Anthem’s offer. At this time, we are awaiting Memorial’s response. We remain hopeful that Memorial will agree to this offer before their termination date on November 28, 2019.
November 20, 2019
Anthem Blue Cross and Blue Shield met with Memorial Hospital and Health Care Center on November 20. We presented our final counteroffer, which included over half of Memorial’s top three requests, which they outlined to us at the start of these negotiations.
Our goal throughout has been to maintain affordable healthcare for Anthem consumers in Dubois and surrounding counties. This proposal is a compromise that provides fair reimbursement to MHHCC while guaranteeing that Anthem consumers will continue to have access to MHHCC at an affordable rate. We remain hopeful that MHHCC will agree to this reasonable offer. Our final meeting will occur Friday, November 22.
November 15, 2019
Anthem presented a new proposal to MHHCC during a meeting November 13. In the last three weeks, Anthem has submitted two counterproposals, but unfortunately MHHCC has declined each time. Additional meetings are scheduled for November 20 and November 22.
October 14, 2019
Indiana businesses and consumers face a challenge with the cost of healthcare. Anthem Blue Cross and Blue Shield is committed to addressing the issue in numerous ways, including the contracts we negotiate with doctors and hospitals.
Our goal is keep Memorial Hospital and Health Care Center in our network. But if we cannot reach an agreement by November 27, 2019, they would become the only acute care facility in Indiana not in our network.
We are committed to continuing negotiations. Thank you for your patience as we continue to work on your behalf to keep healthcare affordable.
Q: Why is Anthem negotiating a contract with Memorial Hospital and Health Care Center (MHHCC)?
A: A multi-year contract between Anthem and MHHCC expires November 27, 2019. Contract talks are a normal and routine part of what we do. Our goal is to reach an agreement that gives consumers access to affordable care, while also ensuring that we’re paying healthcare providers and hospitals fairly. We’ve been in discussions for several months, but have yet to reach agreement on a new contract with MHHCC. If we are unable to reach mutually agreeable terms, MHHCC facilities will be out of network beginning November 28, 2019.
Q: What about the physicians who are employed by MHHCC? Are they part of this negotiation, also?
A: MHHCC has chosen to include the physicians they employ in these negotiations. They are requesting a double digit increase in reimbursement from Anthem. If we do not agree to that increase, MHHCC physicians would also be out of network beginning November 28, 2019.
Q: What does out of network mean?
A: Healthcare providers contract with Anthem Blue Cross and Blue Shield to become part of our network. Doctors and hospitals that are in-network agree to provide medical services to Anthem members at discounted reimbursement rates spelled out in their contract with Anthem. Members always pay the least out of pocket when seeking care from an in-network provider. On the other hand, providers who do not contract with Anthem are considered out of network, meaning they do not have to accept Anthem’s reimbursement as payment in full and can bill their Anthem patients for any amount not covered by Anthem’s reimbursement.
Q: Which Anthem insurance plans are affected by the negotiations?
A: Anthem commercial plans, Medicare Advantage plans, Anthem Worker’s Compensation and Medicaid plans.
Q: What are the main areas of concern in these negotiations?
A: Our top priority during these negotiations continues to be protecting consumers’ access to affordable health care. Since the majority of Anthem’s employer customers are self-insured, they pay for their employees’ medical care directly, while Anthem receives an administrative fee for processing their claims. Therefore, increases in the cost of healthcare mean higher costs for employers and their employees.
Q: Why doesn’t Anthem just pay MHHCC what it deserves?
A: We believe MHHCC is paid fairly. According to a recent study by the Rand Corporation, hospital costs in Indiana are the highest among the 25 states they surveyed. The same study showed that private insurers like Anthem reimburse MHHCC nearly three times what Medicare would pay. In addition, the study showed MHHCC is paid more than similar size hospitals in Indiana and more than premier healthcare facilities in the Midwest such as BJC Healthcare in St. Louis and the Cleveland Clinic in Ohio. Nevertheless, MHHCC is requesting a 9% increase from Anthem, or $5 million more per year. That’s $20 million over the life of the contract, costs that would be absorbed by employers and their employees in the area.
Q: Are there any changes now that I should be aware of?
A: Nothing changes for now as the current contracts remain in effect until November 27,2019.
Q: What if I already have services or a procedure scheduled at a Memorial Hospital and Health Care Center facility after the contract-end date?
A. If MHHCC chooses to leave the Anthem network, you may have to pay more for careat MHHCC as they could bill you for any charges not covered by Anthem’s reimbursement beginning November 28, 2019. Anthem will assist you in transitioning your care to an in-network provider where your out of pocket costs will be less.
Q: What other participating Anthem network hospitals are available in the vicinity?
A: The Find a Doctor feature available on www.anthem.com can be used to locate an in-network doctor or hospital in your area. You can also check Anthem’s new mobile app Sydney or call the number on the back of your Anthem ID card to speak with a customer service representative.
Q: If the contract expires and a new agreement isn’t reached, can I still see my doctor or receive care at MHHCC?
A: Certain members may be eligible to continue to receive care at MHHCC following thecontract termination. If you have questions about continuation of care, or to see if you are eligible, you can call the number on the back of your Anthem ID card.
Q: Who should I call with questions?
A: This website will be updated with the latest information about the negotiations. Youmay also call the number on the back of your Anthem ID card with any questions.
Q: Are you currently meeting in an effort to reach an agreement?
A: Yes, we have been negotiating for several months. Both sides have agreed to continue discussions in an effort to reach a new agreement.
Materials from the Symposium: