Charleston, S.C.-based MUSC Health hospitals and physicians will go out of network for Cigna Healthcare if they fail to establish a contract by the end of June, according to both organizations.
An agreement would cover Cigna’s commercial members with HMO, PPO and Open Access Plus plans. MUSC said it has spent months working with Cigna on the negotiations.
“MUSC Health and Cigna operate with fundamentally different missions,” an April 28 MUSC statement said, citing the insurer’s need to deliver returns for shareholders. MUSC said Cigna “conditioned an agreement on substantial changes to the way payments for healthcare services are made.”
For its part, Cigna’s website emphasized that employers and payers would ultimately pay for the increases in care reimbursement.
“MUSC is seeking to continue a pricing structure that is out of step with current market standards and does not reflect the simpler, more predictable pricing approaches used by most providers today,” a Cigna Healthcare statement said. “We’ve proposed rate increases close to what the hospital requested and explored alternative options, but MUSC has not offered flexibility around solutions that would strengthen cost guardrails and support more predictable, sustainable costs for families and local employers.”
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