MU Health Care disputes Anthem’s rate-increase claims as negotiations continue
COLUMBIA, Mo. (KMIZ)
After failing to reach an agreement with Anthem Blue Cross Blue Shield by the March 31 deadline, MU Health Care says it remains open to further discussions over commercial and Affordable Care Act insurance plans with the provider.
“Negotiations are still happening right now,” Tonya Johnson, MU Health Care’s Health System Chief Operating Officer, told ABC 17 news. “We're looking to come to the table and have some meaningful conversations with Anthem and they would be the next steps that we're anticipating would happen.”
MU Health Care has also taken issue with Anthem's statement, claiming that it was “demanding a 39% price increase over the next three years”.
Johnson said MU Health Care started negotiations wanting between an 11-13% increase over the next three years, which would add up to roughly 39%, but claims MU Health Care has made efforts to adjust the increase with Anthem.
“We've come down considerably and made considerable compromises in what we've put across the table,” Johnson said. “The challenging part for us is that Anthem is offering us 1-to-2% increases in rates every year annually. That doesn't cover our inflationary costs of supplies, labor, technology, pharmaceuticals.”
An Anthem spokesperson disputed the claim in an email to ABC 17 News.
"The numbers MU Health Care has shared are not accurate. Anthem proposed rate increases that exceed the Consumer Price Index (CPI) for each year of a three-year agreement—offers that are consistent with what other Missouri health systems have accepted. MU Health Care has demanded a 39% increase, which remains unsustainable," the spokesperson wrote.
Johnson claims recent tariffs have added to inflationary costs, and that a 1-2% increase would make it difficult for MU Health Care to provide care for patients who depend on them while still covering expenses.
“We're seeing an average increase between 6 to 8% every year,” Johnson said.
When asked if patient numbers have declined since the split with Anthem, MU Health Care acknowledged some patients have expressed concerns.
“We're certainly seeing uncertainty. Patients are unsure of where they can get care if they can still get care, so there's been adjustments in our schedules, but we are definitely still busy and still providing care for people here,” Johnson said.
MU Health Care has created a hub for patients with insurance questions, such as continued care paperwork and what out-of-pocket costs might look like. The number for the hub is 573-771-CARE.
“We've been planning [the hub] for some time in the event that we would go out of network, but this is something newly put in place to really centralize the work, make it easier for our team members and less burdensome for them, Johnson said. “But also one-stop shopping for our patients. We want to make it as convenient as possible for them.”
However, Anthem pushed back, saying that some of its members have been turned down for care.
"We’re also aware of instances where Anthem members with approved continuity of care have reportedly been turned away by MU Health Care. Members—whether in or out of network—who qualify for continuity of care should not be denied access," an Anthem spokesperson told ABC 17 News. "If this has occurred, we encourage them to call the Member Services number on the back of their ID card so we can assist immediately."
Anthem Blue Cross Blue Shield says it is working with other Mid-Missouri health care providers, including Boone Hospital, SSM St. Mary's, Moberly Regional Hospital, and Jefferson City Medical Group. Some of those hospitals have since reported an influx of calls about Anthem insurance.
SSM Health Medical Group in Mid-Missouri says it has been busy in recent weeks fielding calls from Anthem insurance holders.
"Our staff has received numerous calls from local residents concerned about the changes, and we are happy to assist them in establishing care with our providers," SSM Health Medical Group said in a statement to ABC 17 News. “SSM Health St. Mary's Hospital and SSM Health Medical Group in Mid-Missouri accept Anthem Blue Cross and Blue Shield – Commercial, Govt. Marketplace, Medicare Advantage, Blue Card. “
The Jefferson City Medical Group, which is in-network with all regional Anthem plans, says they have also received an influx of calls from new patients.
“JCMG has received an increase in phone calls and appointment requests from Anthem members seeking care, and our providers and staff are working to accommodate as many new patients as possible to ensure access to care. With over 30 specialties, an on-site infusion center, on-site radiology services, and a full-service laboratory, JCMG is dedicated to delivering comprehensive care to Mid-Missouri,” JCMG told ABC 17 News in a statement.
Meanwhile, Boone Health says it has established a new phone line for insurance questions after receiving increasing calls and emails.
“We certainly have been receiving more calls, more emails, more questions to our helplines. And we are certainly hearing from patients that are asking what their options are and switching over,” Boone Health spokesman Christian Basi said.
Basi says that Boone Health is already in the process of growing it’s care, with ongoing discussions about expanding into Audrain County. He also says that the demand of health care in mid-Missouri is continuing to rise.
“We want to make sure that we have we're providing Mid-Missouri with the best quality care and that we're giving them as much access as possible. And that means making sure that we have good relationships with the various insurance companies that serve the mid-Missouri community, and that includes Anthem,” Basi said. “Right now our relationships with our insurance companies are very, very strong and we don't see that changing in the foreseeable future.”
