Payer Contracting

Florida Blue and Fort Lauderdale-based Broward Health went out of network on July 1. The network split impacts all Broward hospitals and physicians for Florida Blue’s commercial, ACA and Medicare Advantage members. Florida Blue notified around 18,000 people about the…

Representatives from Anthem Blue Cross Blue Shield and Columbia-based University of Missouri Health Care testified before a state committee on June 30 regarding a disagreement over reimbursement rates.  Since April, MU Health Care’s physicians and facilities have been out of…

UnitedHealthcare, Centene, Elevance Health and other insurers have picked up Medicaid managed care contracts in 2025.  Here are three states awarding new contracts Becker’s has reported so far in 2025: 

Several major health systems and insurers went out of network on July 1. Contract disputes between insurers and health systems are down in 2025 compared to the second half of 2024. In the first quarter of 2025, 26 total disputes…

UnitedHealthcare and Providence, R.I.-based Brown University Health have mutually agreed to go out of network on July 1 for Medicare Advantage plans. Brown’s hospitals in Rhode Island will be out of network for UnitedHealth’s MA plans, including D-SNP and group…

Blue Shield of California and University of California Health hospitals, clinics and physicians across six academic health centers will go out of network on July 10 without a new contract in place. The network split would affect commercial, ACA, Medicare…

Tupelo, Miss.-based North Mississippi Health Services is out-of-network with UnitedHealthcare Medicare Advantage plans, as of June 1.  The split affects UnitedHealthcare MA and dual-eligible special needs plans. North Mississippi Health Services is still in-network with UnitedHealthcare commercial, individual and Medicaid…

Cigna and Pittsburgh-based Allegheny Health Network will be out of network on July 1 without a new contract in place, the Pittsburgh Business Times reported. According to the report, about 20,000 Cigna members have used an AHN provider within the…

Aetna and Seattle-based UW Medicine facilities and physicians went out of network on June 1. Aetna’s commercial and Medicare Advantage members have lost in-network coverage at UW because no contract agreement was reached. There will be no impact to provider…

Cincinnati-based Bon Secours providers and facilities in South Carolina are facing a network split with UnitedHealthcare. If an agreement is not reached before July 1, the two organizations will be out-of-network across commercial, ACA, Medicare Advantage, and veteran plans. Some…