Payer Contracting

Aetna and Allentown, Pa.-based Lehigh Valley Health Network have reached a new deal, avoiding a contract split that would have affected thousands of patients, the Morning Call reported Nov. 17. 

UnitedHealthcare and Raleigh, N.C.-based WakeMed have signed a multi-year contract that restores in-network access for thousands of patients.

Centene is the largest Medicaid managed care organization, serving 15.7 million low-income members nationwide. According to federal policy publication ExecutiveGov, these are some of the company's largest government contracts with details publicly available:

If payer-provider disputes were a reality TV show, just a few years ago viewers would have been hard to come by. 

The nearly 15,000 independent pharmacies dropped from Tricare's network could be reinstated, Military Times reported Nov. 14.

CDPHP and St. Peter's Health Partners are taking shots at each other during routine contract negotiations — but despite the bad blood, both sides say they anticipate reaching an agreement by the end of the year, WAMC reported Nov. 11. 

Dec. 31 deadlines are looming for some payer-provider contracts, while other disputes are dragging on and leaving patients out of network. Here are five updates on ongoing contract negotiations:

Aetna and Allentown, Pa.-based Lehigh Valley Health Network will be out of network next year, The Morning Call reported Nov. 10. 

New Jersey's police union is pressing state officials to divulge whether Horizon Blue Cross Blue Shield of New Jersey will face financial penalties following 20% higher premiums among some public employees, Bloomberg reported Nov. 8.

Nebraska has delayed the signing of new Medicaid managed care contracts until a protest filed by a losing bidder is resolved, the Omaha World-Herald reported Nov. 6.