What You Should Know:
– Mercy, a healthcare provider in Missouri, has announced its plans to terminate contracts with Anthem Blue Cross Blue Shield in the state.
– This decision comes after months of negotiations, during which Mercy sought to address concerns about rising costs and administrative burdens imposed by Anthem.
A Growing Disparity
Mercy has experienced a significant disparity between the rising costs it faces and the profits generated by managed care companies like Anthem. While Mercy’s average cost per inpatient stay is 27% below the state average, Anthem’s profits have soared, with a 24.12% increase in net income in 2024.
Prioritizing Patient Care
Mercy’s decision to terminate contracts with Anthem is driven by a commitment to providing the best possible care for its patients. The company believes that Anthem’s complex systems and administrative burdens create obstacles for patients seeking timely and affordable care.
Impact on Patients
While the termination of contracts will result in Mercy becoming out-of-network for Anthem patients starting January 1, 2025, Mercy will continue to serve Anthem patients through its retail pharmacy services. Mercy encourages patients to express their concerns to Anthem and advocate for their healthcare needs.
“Our focus remains on safeguarding our patients and ensuring they receive the low-cost, high-quality care they deserve with insurance coverage that provides the greatest amount of protection for their health,” said Dave Thompson, Mercy’s senior vice president of population health and president of contracted revenue. “We know this news will be concerning for hundreds of thousands of Mercy patients with Anthem BCBS. We will continue to negotiate in good faith with Anthem in hopes of avoiding any disruption to our patients at the end of the year – particularly those patients in need of prolonged, coordinated care. However, patients and employers considering which health plans to purchase for 2025 should consider whether Mercy, the largest health system in the state, will be in the plan they purchase.”
