Payer Contracting

North Carolina is moving ahead with its plans to hand over its State Health Plan to Aetna, rejecting protests from Blue Cross Blue Shield of North Carolina and UMR, a UnitedHealthcare subsidiary. 

More than two weeks after Clovis, Calif.-based Community Health System went out of network with several major insurers, hospital staff members are speaking out after being left without covered access to the system's facilities.

UnitedHealthcare is planning to terminate its Medicaid managed care contract with Philadelphia-based Temple University Health System on Feb. 1 if the sides are unable to strike a new deal, the Philadelphia Business Journal reported Jan. 17.  

UMR, a subsidiary of UnitedHealthcare, is protesting North Carolina's decision to award its state health plan contract to Aetna, the Winston-Salem Journal reported Jan. 15. 

Nashville, Tenn., Mayor John Cooper sent letters to Vanderbilt University Medical Center and Humana officials urging the sides to prevent "what could otherwise unfold into catastrophic scenarios" if the health system splits with the insurer's Medicare Advantage plan. 

Blue Cross and Blue Shield of North Carolina is appealing North Carolina's decision to award its state employee health plan contract to Aetna. 

Vanderbilt University Medical Center announced it will drop Humana and Wellcare of Tennessee Medicare Advantage plans effective April 1, NBC affiliate WSMV reported Jan. 10. 

Some payers and health systems have split in recent weeks, unable to meet year-end contract deadlines. Others are facing looming deadlines to reach agreements without disrupting patient care. Here are nine ongoing contract disputes and failed negotiations, as of Jan.…

Despite coming to an agreement to keep Regence BlueShield of Washington commercial members in-network at the Polyclinic and Everett Clinic, the payer's Medicare advantage members are still left in limbo, The Daily Herald reported Jan. 10. 

Anthem Blue Cross could go out of network with Fredericksburg, Va.-based Mary Washington Healthcare if the two sides can't agree on a new contract by March 1, The Free Lance-Star reported Jan. 7.