Payer Contracting

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. 

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. 

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.