Mercy Health to split with Elevance managed care plans July 1 without new contract

Cincinnati-based Bon Secours Mercy Health said it will go out of network with Elevance Health Medicaid managed care plans on July 1 if the sides are unable to reach a new agreement. 

The move would affect Mercy's 21 hospitals across Ohio, according to information posted on its website. 

Mercy alleged that what Elevance currently pays physicians, nurses and other caregivers is "not sustainable or market competitive." 

"Their current reimbursement rates — which are substantially less than those we receive from other payer partners in the market — have not kept up with inflation or labor costs and are overwhelmingly inadequate to account for the cost of providing safe and quality care," Mercy said in the post. 

An Elevance spokesperson told Becker's in a statement that if the insurer were to "agree to their request for higher rates, on top of the reasonable increases we are already providing, the result would be higher costs borne directly by businesses and individuals across Ohio. 

"We cannot agree to allow Bon Secours Mercy to threaten to put the most vulnerable in our population at risk in an effort to leverage more revenue from people and businesses as this runs counter to our commitment to providing access to affordable care." 

Mercy said on its website it is continuing to negotiate with Elevance.

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