Centene and Springfield, Mo.-based CoxHealth will go out of network Feb. 16 after the two sides were unable to reach a new contract agreement, Springfield News-Leader reported Jan. 9.
Payer Contracting
Cost savings and more price transparency were cited as reasons why North Carolina ended a 40-year relationship with Blue Cross Blue Shield and chose Aetna to administer employee health benefits.
Blue Cross Blue Shield of Texas and Ascension hospitals in Texas are facing a looming Feb. 1 deadline to avoid a split that could impact 66,000 patients, the Austin-American Statesman reported Jan. 6.
Cigna of Ohio and Cincinnati-based Mercy Health reached an agreement to keep over 12,000 patients in-network, the Cincinnati Enquirer reported Jan. 5.
New Jersey has extended its employee benefits contract with Horizon BCBS despite state officials and media reports alleging that previous contract terms have not been upheld by the payer, Bloomberg reported Jan. 4.
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UPMC Health Plan is adding a preferred pharmacy network to its ACA plans, reducing the number of pharmacies available to members by 60 percent, The Pittsburgh Post-Gazette reported Jan. 5.
Aetna and Munster, Ind.-based Community Healthcare System have agreed to a contract extension, avoiding a split that would have left Aetna commercial and Medicare Advantage members out of network.
Aetna will manage health insurance for more than 740,000 North Carolina state employees, winning a contract BCBS North Carolina has held for over 40 years.
As year-end deadlines approached, several payers and providers struck new deals to keep patients in-network.
Although California is awarding more payer contracts to its Medi-Cal program, Molina Healthcare — who won big in the state's initial August 2022 award — is expecting its California Medicaid revenue will double.