ST. LOUIS — Mercy has announced its intent to end contracts with Anthem Blue Cross Blue Shield (BCBS) at the end of the year if the companies can’t reach an agreement.
According to a press release from Mercy, the contracts that will end include all commercial, Medicare Advantage, Affordable Care Act (ACA) marketplace, managed Medicaid plans (Healthy Blue) and HealthLink (which falls under the Anthem BCBS umbrella).
Mercy says the move comes as an effort to “remove much of the red tape that makes it increasingly difficult for patients to navigate Anthem’s system and creates a burden and barrier for patients to receive care when it’s medically necessary.”
Unless a new agreement can be reached, Mercy says it will move out of network as of Jan. 1, 2025. This notice does not impact Mercy retail pharmacy services, which will allow Mercy Pharmacy’s locations to continue serving Anthem patients with in-network coverage.
“These technicalities disrupt patient care and, in some cases, can be life-threatening,” Dave Thompson, Mercy’s senior vice president of population health and president of contracted revenue, said in a statement.
“They are administrative tasks dictated and mandated by Anthem, and they are a barrier to timely, appropriate patient care and can shift the cost of health care away from the insurance provider to those less able to afford it – our patients. Our patients have enough to worry about, as they are often in the middle of a personal health care crisis. They shouldn’t have to worry about whether their insurance company will approve their coverage. They should be able to solely focus on their health and the health of their family members.”
The press release also says that while Mercy and other healthcare organizations are facing rising costs, managed care companies like Elevance Health (the corporate name for Anthem) are turning profits. According to Mercy, Elevance Health reported a 24.12% increase in income and a 24.29% increase in its net profit margin.
FOX 2 reached out to Anthem for a response. A spokesperson sent us the following statement:
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. 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.
Anthem members can find out the latest information by visiting www.anthem.com/MercyMO.
