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Keeping Healthcare Affordable for All Missourians

February 13, 2025
Important Information for Anthem Blue Cross and Blue Shield Members About Our Negotiations with University of Missouri Health Care
 
MU Health Care has chosen to leave Anthem Blue Cross and Blue Shield in Missouri’s network effective April 1, 2025.
 
 
Until they return to Anthem’s network, our members covered through employer-sponsored, individual, Taft-Hartley, and Medicare Advantage health plans may pay much more for care at MU Health Care doctors and hospitals. Anthem Medicare Supplement health plan members are not impacted, and their coverage at MU Health Care is unchanged.
 
What Happened?
Despite good faith efforts including offers of reasonable payment increases that exceed the Consumer Price Index (CPI) each year over three years, Anthem Blue Cross and Blue Shield was unable to reach a new contract with MU Health Care. As a result, MU Health Care is no longer in Anthem’s network as of April 1, 2025. This means that until they return to our network, our members may pay considerably more for care at MU Health Care’s doctors and hospitals than they would at an in-network care provider. Please see below for assistance in transferring to an in-network care provider or, for members previously in treatment at MU Health Care for serious or complex health conditions, options to continue care with your current provider.
 
MU Health Care continues to demand the largest price increases Anthem has ever seen. If we were to accept these rates, it would place a massive financial burden on Central Missouri employers and families covered by Anthem. We cannot agree to price hikes of this magnitude for our members. Standing up for affordable care for all Missourians is part of our mission.
 
What Now?
For members covered by Anthem Medicare Advantage health plans
MU Health Care has chosen to end its contract to serve Anthem Medicare Advantage health plan members effective April 1, 2025. This means Anthem Medicare Advantage members may pay more for care after that date at MU Health Care. Please see below for information about alternative care providers in our network and additional steps we’ve taken to assist members currently receiving treatment at MU Health Care.
 
For members covered by Anthem employer-sponsored, Taft-Hartley programs, small business, and individual plans
We continue to negotiate with MU Health Care in hopes they return to our network soon. Until then our members may pay much more for care at MU Health Care than at an in-network provider. We know MU Health Care is an important provider for many families. But we know that affordability is also important, and we are committed to protecting access to high-quality, affordable care for our members and their employers.
 
MU Health Care’s proposed price increases would mean much higher co-pays and other out-of-pocket expenses for our members. In addition, 80% of Anthem members are covered by employers who directly pay their employees’ healthcare bills. That means that Central Missouri employers would have to shoulder the burden, instead of using that money to invest in employee wage increases, hiring, and business growth.
 
Our Offer: Fair Payment Increases That Keep Healthcare Affordable
We continue to offer MU Health Care payment increases that exceed the current Consumer Price Index each year for the next three years. These increases are fair, in line with other Missouri health systems, and ensure affordability while supporting the care MU Health Care provides. We also continue to offer performance-based incentives that reward MU Health Care for delivering high-quality, value-based care— improving health outcomes and helping to control costs without putting an extra burden on employers, employees, and families.
 
Affordable healthcare is essential. MU Health Care's proposed increases would create financial challenges for families, businesses, union members, and the state as a whole.
  
High Quality Care is Available at Other Central Missouri Care providers in Anthem’s Network
We have coordinated with our other Central Missouri care provider network partners to ensure our members will have access to high-quality care. These include:
Continuity of Care: Our top priority is making sure our members receive the care they need
It is important that our members’ care is not disrupted while they look for a new doctor or facility that is in their plan’s network. Members may be eligible to keep receiving care for certain conditions or scheduled services at MU Health Care for a limited time.
 
Members previously receiving care at MU Health Care for serious and complex conditions -- including urgent surgeries that are already scheduled, treatments for terminal illness, ongoing treatments for a serious and complex condition, care for pregnancy, and more - may qualify for in-network benefits with MU Health Care for a limited time or until their treatment is complete.
 
Members should contact our member service center at the number on their ID card to find out whether they are eligible for continuity of care, or if they have already been pre-approved for continuity of care.
 
Please note that coverage for emergency care will be provided according to the member’s policy benefits at in-network cost shares.
 
Members can also complete and submit a Continuity of Care Request Form if certain circumstances apply. If approved, Members will be eligible to continue care with a MU Health Care provider at the network benefit level until it is medically appropriate to transfer care to an alternate in-network provider. Members should not complete and submit the form if they are not currently receiving ongoing care or if they do not have upcoming services scheduled. Members may submit a continuity of care request form if any of the following circumstances apply:
  • You are in treatment for a serious and complex condition. (This can be a sudden illness that requires specialized treatment in order to avoid death or permanent harm. It can also be an ongoing illness that is life-threatening or potentially disabling and requires specialized care over a long period of time. This may include mental health conditions.)
  • You are in a hospital or other inpatient facility.
  • You are scheduled for non-elective surgery by your current doctor, including your post-operative care for the surgery.
  • You are pregnant.
  • You are terminally ill.
Members receiving certain types of treatment/care at MU Health Care were proactively notified and preapproved to continue their current treatment with MU Health Care at their plan’s in-network benefit level. Anthem automatically extended these in-network benefits for the care they’re receiving from MU Health Care through June 29, 2025, for their current diagnosis. Those members don’t need to do anything to receive this extension. This preapproval does not apply to any other diagnosis or to other members of their family covered on their insurance with Anthem. If members need care at MU Health Care beyond June 29, 2025, our member service center can tell them how to apply for a network exception request based on need for specialized services in their area.
  • We continue to assist our members with transitioning care to one of the many other Central Missouri care providers in our network, including Boone Health, SSM Health, Jefferson City Medical Group, and Moberly Regional Hospital.
Frequently Asked Questions
Setting the Record Straight: Anthem’s Ongoing Negotiations with MU Health Care
MU Health Care continues to share misleading and inaccurate information about Anthem—while creating disruption for our members. It’s time to set the record straight.
 
Anthem remains focused on meaningful dialogue and hopes MU Health Care will direct as much energy toward reaching an agreement as they have toward promoting a misleading narrative in the community. Our priority remains protecting affordability and ensuring access to high-quality care for the people of Missouri.
 
What should I do if I need emergency medical care from MU Health Care?
Members should always call 9-1-1 or go to the nearest emergency room in a life-threatening situation. Coverage for emergency care will be provided according to the member’s policy benefits at in-network cost shares.
 
Can I still go to MU Health Care for non-emergency care?
Yes. Most Anthem health plans include coverage for services at out-of-network care providers. Anthem members may receive care at MU Health Care as they did previously, and Anthem will reimburse the member directly per the terms of their health plan. However, it’s important to note that with no contract in place, MU Health Care may bill you above and beyond Anthem’s payment for services rendered. Using in-network care providers is always the least expensive option. For help moving to an in-network care provider, please login to the Sydney Health app or Anthem.com, or call our customer service center at the number on your ID card.
 
Who is impacted?
Anthem members enrolled in employer-sponsored, Taft-Hartley, small business, Medicare Advantage, and individual plans will be impacted.
 
Please note: Anthem Medicare Supplement, Heathy Blue Medicaid, and University of Missouri Student Advantage plan members are not impacted.
 
Why is MU Health Care no longer in Anthem’s network?
MU Health Care chose to leave Anthem Blue Cross and Blue Shield in Missouri’s network effective April 1, 2025. They continue to pursue significantly higher costs over the next three years for patients covered by Anthem commercial health plans.
 
Has Anthem made a fair offer to MU Health Care?
Yes. Anthem proposed rate increases that exceed the Consumer Price Index (CPI) each year over a three-year agreement. These offers are consistent with rate increases with other Missouri health systems—true local peers of MU Health Care. Anthem also included performance-based incentives to reward MU Health Care for delivering high-quality, value-based care. Unfortunately, MU Health Care rejected these offers and instead chose to disrupt patient access.
 
Who actually pays for healthcare under Anthem commercial plans?
More than 80% of the employers we serve are self-funded, meaning they pay directly for their employees’ healthcare. Anthem simply administers those benefits. MU Health Care’s proposed rate increases would shift costs directly onto local employers, union plans, and Missouri families in the form of higher copays and other out-of-pocket expenses.
 
How large is the financial impact of MU Health Care’s proposed rate increases?
MU Health Care’s current ask is the largest percentage increase any Anthem plan has seen. Ever. If accepted, it would place a massive financial burden on Central Missouri employers and families—undermining healthcare affordability across the region. We are negotiating on behalf of our members and employers to protect them from these unnecessary increases. We are committed to keeping care affordable and protecting the interests of our members, employers, and public institutions who would bear those costs.
 
Is MU Health Care underpaid compared to other academic medical centers?
No. Academic medical centers are not reimbursed equally. Rates are based on quality outcomes, patient complexity, and local cost benchmarks. MU Health Care is attempting to justify its unprecedented price increases by comparing itself to state-affiliated academic health systems across the Midwest. However, those hospitals have earned significantly higher quality ratings than MU Health Care. Being an academic institution does not entitle any provider to unchecked rate increases—especially when those costs would fall directly on hardworking Missourians.
 
MU Health Care is not-for-profit. Doesn’t that mean they’re putting patients first?
Not-for-profit status doesn’t exempt a provider from accountability. MU Health Care also benefits from higher reimbursement rates through the federal Case Mix Index, which adjusts payments based on the complexity of the patients they serve. These higher rates are already built into the system. Despite this support, MU Health Care continues to demand unsustainable price increases. Anthem has a responsibility to protect the value of every healthcare dollar—especially when taxpayer and employer funds are involved. Being a not-for-profit should not be a blank check, particularly when that funding isn’t translating into better affordability or higher quality for the community.
 
How does Anthem perform when it comes to billing and claims processing?
According to the Healthcare Financial Management Association (HFMA), high-performing organizations typically keep accounts receivable over 90 days below 10%. Anthem’s rate with MU Health Care is significantly below that benchmark. Anthem is committed to timely, accurate claims processing. In Missouri, 96% of claims are paid within 14 days and 99% within 30 days. We also work to educate our provider partners and their staff to reduce claims submission errors, which are a leading contributor to payment delays. This collaborative approach is one reason nearly all of Missouri’s healthcare providers choose to participate in Anthem’s networks.