Anthem Negotiations With Northern Light Health

Important Information for Anthem Blue Cross and Blue Shield Members About Our Negotiations with Northern Light Health

We’re working to improve access to affordable healthcare in Maine. Our current contracts with Northern Light Health expire later this year, and we are negotiating in good faith to keep Northern Light Health in our network. However, Northern Light Health wants to drastically increase the prices it charges to its patients and their employers.

LATE AUGUST UPDATE:

On Friday, August 22, Anthem reached out to Northern Light Health to suggest bringing in a mediator to help us reach a new contract agreement. We are pleased that on August 26, Northern Light let us know they agree with Anthem about taking this next step in our negotiations.

Get the full story: Anthem's open letter to Mainers.

Click here for Anthem's open letter to Mainers

Northern Light Health has been sharing misleading information.

Click here to get the facts

The Core Issue: A Nearly 30% Increase in Healthcare Prices

Our negotiations focus on healthcare affordability. Northern Light Health seeks to increase its prices by nearly 30% over the next three years. That would mean nearly $200 million in new healthcare costs — a bill Northern Light Health’s patients and Maine employers, unions, school districts, and city governments would pay. Healthcare price increases of this magnitude could cause people to avoid care they need, including important preventive care. Some examples of how costs would increase include:

- $580 more for an ER visit

- $1,200 more for a colonoscopy

- $4,400 more to deliver a baby at Northern Light Health

- $17,400 more for a knee or hip replacement

- $36,600 more for open heart surgery

Here's What's Happening

When Our Contract Expires

Anthem’s network contracts with Northern Light Health will expire later this year. These contracts set the prices Northern Light Health charges to its patients who have Anthem employer-based, individual, and Medicare Advantage health plans. Our goal is to improve healthcare affordability for the patients, employers, and taxpayers who pay for care.

If we are unable to reach a new agreement:

All Northern Light doctors, specialists, other professionals, outpatient clinics, and other non-hospital facilities will exit Anthem’s network for employer-sponsored and individual health plans on September 30, 2025. This includes hospital-based physicians.
Northern Light hospitals will exit Anthem’s network for employer-sponsored and individual health plans on December 31, 2025.
All Northern Light facilities and professionals will exit Anthem’s network for Medicare Advantage health plans on December 31, 2025.

We know these different contract expiration dates are confusing. We asked Northern Light to align all dates to December 31, 2025, to avoid additional confusion and care disruption for patients, but they refused to do so.

Our Commitment to Affordability

Anthem is dedicated to improving access to high-quality, affordable healthcare for all Mainers. Here’s why:

According to KFF surveys, about half of U.S. adults say it’s difficult to afford healthcare costs and, alarmingly, one in four adults delays needed care because of high costs. Hospital price increases raise patient costs through higher copayments, deductibles, and insurance premiums.
Employers are also affected; higher hospital prices lead to higher insurance premiums, and many Maine employers pay their employees’ healthcare claims directly – so high healthcare costs disadvantage them compared to other states. These costs can limit wages, hiring, investment, and growth.

We negotiate on behalf of our members and Maine employers to secure affordable care at Northern Light Health and all our provider partners.

Our Proposal: Fair Payment for Northern Light Health, Affordable Care for Our Members

We’ve asked Northern Light Health to lower its price increases to match those of other Maine health systems. Our offers include payment increases that are higher than the inflation rate and improve affordability for our members. We also propose incentives that offer Northern Light Health the opportunity to earn millions more by delivering high quality care.

Together, our offered rates would significantly moderate cost trends for Northern Light Health’s patients and their employers, while still fairly compensating Northern Light Health for the services it delivers and encouraging better health outcomes.

Commitment to Keeping Northern Light Health in Our Networks

Anthem would like to keep talking with Northern Light Health and on August 22, offered to have a mediator get involved in our negotiations. On August 26, Northern Light Health agreed to this. We want Northern Light Health to remain in our networks, and we’re confident we will reach a new agreement.

Frequently Asked Questions

Northern Light Health has notified us that they intend to leave our networks, although as of late August, both parties are expecting to begin working with a mediator. In the event Northern Light would leave our networks, we have made arrangements with other provider partners to ensure our members can still access high-quality care. Every other hospital in Maine participates in our network, including:

- St. Joseph Hospital, Bangor

- Millinocket Regional Hospital, Millinocket

- Penobscot Valley Hospital, Lincoln

- Redington Fairview Hospital, Skowhegan

- Northern Maine Medical Center, Fort Kent

- Houlton Regional Hospital, Houlton

- Cary Medical Center, Caribou

- Mount Desert Island Hospital, Bar Harbor

- MaineGeneral Medical Center, Augusta

- Maine Medical Center, Portland

- Penobscot Community Health Center, Penobscot County

- Pines Health Services, Aroostook County

- Katahdin Valley Health, locations in Aroostook, Piscataquis & Penobscot Counties

- HealthReach Community Health Care, central & western Maine

- InterMed, Portland

- Martin’s Point Health Care, greater Portland

Please continue to check this website for updates. We will share more information as negotiations continue.

We understand how concerning this is for members receiving care for serious medical conditions. If Northern Light Health exits our network, we’ll help by reaching out to affected members and offering options, including continuing care with their Northern Light Health provider for a limited time.

Any Anthem member receiving care for a serious or complex condition that will continue past the date they leave our network can contact our Member Service Center at the number on their Anthem ID card. You may be able to continue care at Northern Light Health for a limited period depending on the type of care.

We hope so—that’s our goal. But to reach a new agreement, both sides must talk and negotiate. On August 15, Northern Light Health announced they were walking away from the negotiating table. One week later, Anthem suggested both parties agree to mediation, and Northern Light agreed to take this step. We have communicated to them our strong desire to continue negotiations toward an agreement that makes care more affordable for their patients covered by Anthem.

This is a misleading statement because Northern Light fails to say why their annual increases have been smaller than other health systems. Anthem’s payments to Northern Light have followed the terms we both agreed to in our contract. Under that agreement, Northern Light Health had the opportunity to earn millions more through improved health outcomes. Northern Light Health has not met these agreed-upon quality standards and therefore did not earn the additional payments.

Keeping Healthcare Affordable in Maine