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    Thursday, May 09, 2024

    Anthem, Hartford HealthCare fail to agree, boosting out-of-pocket costs

    Anthem Blue Cross Blue Shield and Hartford HealthCare, the parent of The William W. Backus Hospital in Norwich, failed to renew their contract this weekend, meaning many Connecticut residents will face higher out-of-pocket costs for the health network's services.

    The three-year contract ended on Saturday, but the two sides said they are open to continuing negotiations, with the hope of coming to an agreement.

    But since the two sides failed to renew its contract, Hartford HealthCare's hospitals, ancillary providers and employed physicians will be considered out-of-network for patients with any Anthem health insurance as of Sunday.

    That means about 60,000 people would have to pay higher out-of-pocket costs, according to Hartford HealthCare.

    "Anthem is disappointed that we have not come to an agreement with Hartford HealthCare Hospitals (HHC). Unfortunately, after months of negotiations — which included multiple offers by Anthem to increase HHC's reimbursement — HHC will not accept Anthem's offer," Anthem said in a statement Sunday."

    Anthem is seeking for HHC to agree to increases that are comparable to increases accepted by other hospitals in the state. HHC is requesting a rate increase that is two to three times the rate of inflation, and that is not acceptable to us, and not acceptable to our members," the statement said.

    According to a statement from Hartford HealthCare, the health network "worked very hard to avoid this outcome, and we will continue to pursue a resolution with Anthem.

    "We are working hard to resume our partnership with Anthem, and we are committed to reaching a fair agreement with Anthem — one that allows us to operate in a sustainable way while protecting access to caregivers you trust and providing the quality care you deserve. It is our hope that Anthem will work in good faith to agree to a new contract," a statement on Hartford HealthCare's website said.

    Besides Backus, the affected facilities include Hartford Hospital, The Hospital of Central Connecticut in New Britain and Southington, Midstate Medical Center in Meriden  and Windham Hospital in Willimantic, as well as Hartford HealthCare Medical Group and some substance abuse centers and assisted living facilities.

    "With HHC out of network, Anthem is doing everything it can to ensure a smooth transition for our members," Anthem's statement said. "Our priority is to make certain that our members have the right clinical transition plan in place so that services that were in process are not interrupted and that needs for future services will be transitioned to other comparable providers, as appropriate."

    "We're fortunate that we have other in-network providers and hospitals in the area and throughout Connecticut who can meet our members' health care needs," Anthem said.

    Mackenzie Rigg is a reporter for The Connecticut Mirror (www.ctmirror.org). Copyright 2017 © The Connecticut Mirror.

    mrigg@ctmirror.org

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