From Aetna to Anthem, several in-network contracts have been terminated between payers and providers this year, while others are on the verge of the same:
CareFirst BCBS members will go out of network with Johns Hopkins Health System Dec. 5 if the two sides are unable to reach a new contract. Johns Hopkins has notified 350,000 patients about the situation.
Highmark Blue Shield will replace Aetna and CVS Caremark as the health and prescription drug benefits provider for the 39,000 people employed by Penn State starting in 2023.
Oscar Health and Health First Health Plans canceled a $60 million administrative services deal starting next year following challenges with integrating Health First's systems. The partnership officially began Jan. 1, 2022, and was serviced by subsidiary +Oscar.
Aetna's contract with Lubbock, Texas-based Covenant Health expired Aug. 31, leaving almost 9,000 individuals without in-network coverage. Covenant, which is owned by Renton, Wash.-based Providence, operates seven hospitals in Texas and New Mexico.
Anthem Blue Cross and Blue Shield in Maine was dropped for Aetna as the carrier of MaineHealth's employee health plan, starting in 2023. The Portland-based health system has about 22,000 employees.
Termination notice issued:
Florida Blue members will go out of network with BayCare Health System Oct. 1 if the two sides are not able to agree to a new contract. The Clearwater, Fla.-based health system sent letters to 215,000 patients informing them of the decision.
Centene has issued a notice of termination for its contract with Dallas-based Tenet Healthcare beginning next year over reimbursement rates, a move that would affect 3 million members nationwide. The contract is set to expire Dec. 31 and is with 19 Tenet-owned health systems, which includes 60 hospitals across Texas, California, Florida, Michigan and Arizona.