Payer Contracting

Deadlines are looming in some payer-provider contract disagreements, while other ongoing negotiations are leaving members out of network.

Durham, N.C.-based Duke Health is encouraging its patients to select another Medicaid managed care plan after its contract with UnitedHealthcare Community Plan expired Oct. 15. 

Stillwater Medical Center in Oklahoma has ended all in-network contracts with Medicare Advantage plans amid financial challenges at the 117-bed hospital, the Stillwater News Press reported Oct. 14.

Anthem Blue Cross and Blue Shield in Wisconsin is expanding Wisconsin Health Care Marketplace access from nine counties to 68 counties in 2023. 

Toledo, Ohio-based ProMedica and McLaren St. Luke's hospital reached a settlement in a contract dispute, meaning the hospital will treat ProMedica's Paramount Health Plan members in-network, McLaren said Oct. 11. 

Mississippi Insurance Commissioner Mike Chaney suspended mediations between Blue Cross Blue Shield of Mississippi and the University of Mississippi Medical Center after six weeks without progress, NBC affiliate WLBT reported Oct. 11. 

Virginia has awarded a contract to software firm GetInsured to help the state build its own health insurance exchange, instead of using healthcare.gov.

Aetna and Lubbock, Texas-based Covenant Health have ended their dispute over reimbursement rates and signed an in-network contract that went into effect Oct. 1.

Here are 10 Medicaid contract updates Becker's has reported since Aug. 10. 

Mississippi Insurance Commissioner Mike Chaney is urging state lawmakers to enact more regulations to prevent another contract dispute like the one currently playing out between the state's largest insurer and hospital, the Daily Journal reported Oct. 5.