Northern Light Health says it has “made the difficult but necessary decision” to end its relationship with Anthem Blue Cross and Blue Shield, citing payment delays, administrative burdens, and what it calls misleading public narratives from the insurer.
The Brewer, Maine-based system said Anthem has increasingly denied or delayed reimbursements and canceled negotiation meetings over a new contract, according to an Aug. 15 letter from Northern Light President and CEO Timothy Dentry to Anthem Maine President Denise McDonough.
“The Northern Light Health Board has authorized management to immediately discontinue negotiations with Anthem and to focus on assuring patient access, care and service for Anthem members as we transition to out-of-network status with Anthem,” Mr. Dentry wrote. “Should Anthem provide an offer to Northern Light Health that reflects our commitment to delivering and sustaining high-quality care to our patients and communities, we will consider that.”
Northern Light physicians and some ancillary services will be out of network with all commercial Anthem plans on Oct. 1 and all hospital-based services on Dec. 31. The entire health system, including hospitals, clinics, and physicians, will be out of network with all Anthem Medicare Advantage plans on Jan. 1.
“We are disappointed to learn that Northern Light Health is indicating they will discontinue negotiations – with several weeks and months to go before their contracts with Anthem are supposed to terminate,” a spokesperson for Anthem told Becker’s. “We remain committed to working with Northern Light to reach a new contract in the weeks ahead. It’s the right thing to do for our members who are Northern Light patients. So, we intend to keep the lines of communication open.”
“We also remain committed to doing everything we can to keep healthcare as affordable as possible across Maine. Agreeing to the approximately 30 percent price increase (over three years) that Northern Light has demanded is not in the best interest of our members. They would end up having to pay more than $200 million more in health care costs over the life of the proposed three-year contract. Also as we have shared, it’s important to us to compensate Northern Light fairly – based, in part, on important healthcare quality measures. Northern Light has asked that we drop all quality-related compensation from our next contract, which concerns us. Again, we are committed to continuing negotiations with Northern Light Health, and hope that they will agree to keep talking. We both owe it to the Mainers we serve.”
