Anthem Blue Cross and Blue Shield Negotiations with Reid HealthAugust 08, 2022
February 1, 2024
Reid Health has made the decision to leave the Anthem Blue Cross and Blue Shield care provider network on March 18, 2024. They want to further raise healthcare rates after already receiving a 4.7% increase from Anthem on January 1. The price hike they are demanding would cause healthcare costs to go up significantly for people and businesses that use Anthem insurance.
According to Rand Corporation, a third-party research organization, the reimbursement to Reid Health from private insurers in Indiana is more than four times what Medicare pays. And now Reid is demanding even more on top of their already inflated rates.
Over the next three years, Reid Health is proposing to increase health care costs by millions of dollars.
- For consumers, this would mean paying hundreds of dollars more for all services from an MRI to a colonoscopy and thousands more for services such as total knee replacement surgery.
- An employer in the Richmond area with 500 employees, would see its group healthcare costs go up tens of thousands of dollars per year.
We will continue to negotiate on our customers’ behalf to help keep health costs affordable and hope that Reid Health will compromise to find an acceptable resolution for healthcare consumers in the community.
This contract termination would affect members in individual, employer-sponsored, Medicaid and Medicare Advantage plans.
In order to avoid possible out of network costs that would begin on March 18, 2024, we are recommending our members consider scheduling or re-scheduling elective procedures at one of the other health systems in our network, including:
- IU Health Ball Memorial Hospital, Muncie, IN
- Henry Community Health, New Castle, IN
- St. Vincent Randolph Hospital, Winchester, IN
- McCullough-Hyde Memorial Hospital, Oxford, OH
- Wayne Hospital, Greenville, OH
A list of in-network physician groups in the area can be found on the Sydney Health mobile app or at anthem.com.
Why is Reid Health choosing to leave the Anthem network?
Reid Health is the only major health system in Wayne County and the surrounding counties of east central Indiana. Over the years, they have used this to their advantage by demanding unreasonable contract terms. As a result, Reid has become one of the costliest health systems in the state.
What is Anthem doing to reach an agreement?
Our goal is to ensure our members have access to quality, affordable healthcare. We have offered reasonable rates in line with those accepted by other health systems in Indiana. The annual price hikes Reid Health is demanding, on top of their already high rates, would create a substantial and unacceptable increase in costs for our customers. We have also offered opportunities for Reid Health to increase their revenue by tying improved health outcomes for their patients to quality incentives. This is consistent with Anthem’s commitment to value-based care and higher reimbursement for high quality care delivery. Reid Health does not currently participate in our value-based programs. They are insisting on higher prices with no corresponding commitment to improve the quality-of-care Anthem customers receive.
Who will be affected if Reid Health leaves Anthem's network?
All Anthem members receiving healthcare services from Reid Health will be affected, including those in employer-sponsored, Medicaid and Medicare Advantage plans. If Reid Health leaves our network on March 18, 2024, as they have stated, Anthem members will experience much higher costs for non-emergency care received from Reid facilities and physician groups. This is why we always recommend seeking care from in-network providers.
What if I am currently being treated at Reid Health?
We know this is especially concerning for our members currently receiving care from Reid Health. If you are receiving treatment for a serious or complex condition that will continue past March 18, 2024, please contact our Member Service Center at the number on your Anthem ID card. You may be able to continue your care at these facilities for a limited time after that date under certain medical circumstances.
Where can I go for care if Reid Health leaves Anthem’s network? Will I need to find a new primary care physician?
Anthem offers a broad network of hospitals and physicians. You can use the Sydney Health mobile app or anthem.com to find the nearest in-network care providers. You can also contact Anthem Member Services through Sydney Health or by calling the number on your Anthem ID Card.
Will you reach an agreement?
We hope so. Anthem will continue to work in good faith to reach a new contract. However, because we are nearing the end of our current contact, we are recommending that our members consider scheduling or re-scheduling elective care at alternate in-network providers. Please continue to check this site for updates.
What should I do if I need emergency medical care from Reid Health?
It is important to remember that their facilities and physician groups will remain in Anthem’s network until at least March 17, 2023, the date the current contract expires. Even if they leave our network, if you need emergency care you should immediately go to the nearest emergency room or call 9-1-1. Coverage will be provided according to the member’s policy benefits and in-network cost shares.