Payer-provider contract disputes, splits | 2023

Here are the ongoing payer-provider contract disputes and splits Becker's has reported in 2023. 

Network exits and splits

 

Aetna is out-of-network with Baton Rouge (La.) General. The system's hospitals have been out of network with Aetna since November and its physician clinics went out of network in mid-April. 

UnitedHealthcare's Medicaid managed care plan has been out of network with Philadelphia-based Temple Health since Feb. 1, after the two sides were unable to reach a new contract. 

 

Blue Cross Blue Shield of Tennessee's commercial plans have been out-of-network with Memphis, Tenn.-based Methodist Le Bonheur Healthcare since Dec. 31, 2022. The two sides reached a contract for Medicaid members Feb. 8. 

Anthem Blue Cross has been out of network with Clovis, Calif.-based Community Health System since Dec. 31, 2022. The system has negotiated new contracts with Cigna and UnitedHealthcare. 

Regence BlueShield of Washington''s Medicare Advantage plans have been out of network with Optum-owned the Polyclinic and Everett Clinic since Dec. 5, 2022. The two sides reached a deal to keep Regence commercial members in network Dec. 22, 2022. 

Upcoming splits

Cigna Healthcare and Chesapeake (Va.) Regional Medical Center will be out of network June 1 for those with employer-sponsored health coverage.

UnitedHealthcare will be out of network with Phoenix Children's on June 1 if the sides are unable to reach an agreement on a new contract. 

Premera Blue Cross will be out-of-network with The University of Washington Medical Center in Seattle on July 1 if a new contract between the parties is not in place. Affected members include those with commercial, Medicare Advantage, individual ACA and student plans. UW Medicine said around 175,000 patients could be affected, while Premera estimated about 235,000 members could be affected. 

Elevance Health Medicaid managed care plans will go out of network with Cincinnati-based Bon Secours Mercy Health on July 1 if the sides are unable to reach a new agreement. The move would affect Mercy's 21 hospitals across Ohio. 

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