13 payer-provider contract disputes, resolutions in 2018 so far

Becker's Hospital Review reported these 13 contract resolutions and dissolutions between payers and providers since Jan. 1, beginning with the most recent.

1. Piedmont, BCBS negotiations stall ahead of March 31 deadline
Atlanta-based Piedmont Healthcare still lacks a new contract with Anthem Blue Cross Blue Shield of Georgia.

2. Yale New Haven Health, Anthem reach 3-year agreement
Yale New Haven (Conn.) Health will remain in Anthem Blue Cross and Blue Shield's network through 2020 under a new contract.

3. Sarasota Memorial Hospital, Florida Blue reach contract impasse
Sarasota (Fla.) Memorial Hospital and Florida Blue have yet to reach an in-network agreement as a March 31 termination deadline looms.

4. BCBS of Texas: Texas Health Resources seeks nearly $1B in rate increases
Arlington-based Texas Health Resources will no longer be in Blue Cross and Blue Shield of Texas' network if both parties don't reach a new agreement by March 31.

5. 2 OSF hospitals back in network with BCBS
Two hospitals recently acquired by Peoria, Ill.-based OSF HealthCare from Chicago-based Presence are back in network with Blue Cross Blue Shield of Illinois as of Feb. 16.

6. Disney partners with 2 Florida health systems to offer HMO plans: 4 things to know
Walt Disney Co. has contracted directly with Orlando (Fla.) Health, which owns six acute care hospitals, and Florida Hospital in Orlando, which has more than 20 campuses, to roll out two insurance plans for Disney employees in central Florida.

7. Augusta Health gets 3,700+ signatures on petition against Anthem
Fishersville, Va.-based Augusta Health launched an online petition to gather support in its ongoing dispute against Anthem.

8. Aetna inks value-based agreement with Community Care of North Carolina
Aetna's Medicaid members will gain access to Community Care of North Carolina's physician network and care management services under a new agreement.

9. Froedtert South reaches 3-year agreement with Anthem
Kenosha, Wis.-based Froedtert South signed an in-network agreement with Anthem Blue Cross and Blue Shield.

10. Nemours reaches in-network agreement with managed care plan AmeriHealth Caritas
Wilmington, Del.-based Nemours Children's Health System joined Medicaid managed care plan AmeriHealth Caritas' provider network.

11. UPMC, Highmark to extend in-network access to 10+ hospitals
UPMC and Highmark, both in Pittsburgh, inked a deal ensuring Highmark policyholders in-network access to UPMC's community and specialty hospitals.

12. Premier Health, UnitedHealthcare end 7-month impasse; 200k members in-network
Dayton, Ohio-based Premier Health and UnitedHealthcare agreed to a new, multiyear contract, effective Jan. 1.

13. Humana Tricare members regain in-network access to 5 Tenet hospitals
Beneficiaries covered under Humana Tricare regained in-network access Jan. 1 to Birmingham, Ala.-based Brookwood Baptist Health's hospitals, outpatient centers and physician clinics, which are owned by Dallas-based Tenet Healthcare.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months