10 payer, provider contract disputes, agreements

These 10 contract resolutions and dissolutions occurred between payers and providers in the past month, beginning with the most recent.

1. Banner Health, Carondelet among providers not accepting ACA insurance plans in 2017
The fourth open enrollment season for Arizona's insurance exchange boasts health plans with noticeably narrower provider networks than in previous years.

2. CHI Memorial, UnitedHealthcare dispute halts coverage for 5k Chattanoogans
Negotiators from CHI Memorial in Chattanooga, Tenn., and UnitedHealthcare failed to reach a network agreement before their previous contract expired, affecting coverage of roughly 5,000 UnitedHealthcare members in the region.

3. Aetna, Banner Health embark on joint health plan
Aetna and Phoenix-based Banner Health will create and jointly own a health plan company offering employer-based insurance in Arizona's Maricopa and Pinal Counties, with eyes toward statewide expansion. 

4. Jefferson Health expands network contract with Humana
Philadelphia-based Jefferson Health entered into a participation agreement with Louisville, Ky.-based Humana. The agreement will expand the health system's Medicare Advantage network plan, providing healthcare access to nearly 9,000 Humana Medicare Advantage members.

5. Prime Healthcare, BCBS of Alabama reach network agreement at hospital
Prime Healthcare Services and Blue Cross Blue Shield of Alabama reached a network agreement regarding Gadsden, Ala.-based Riverview Regional Medical Center.

6. Mississippi insurance commissioner addresses NMHS, UnitedHealthcare strife
The Mississippi Insurance Department requested reports from North Mississippi Health Services and payer UnitedHealthcare showing efforts to resolve a payment dispute.

7. Memorial Community Hospital & Health System back in network with BCBS plan
Blair, Neb.-based Memorial Community Hospital & Health System primary care providers and a regional Blue Cross Blue Shield plan networked for coverage effective Nov. 1.

8. Long Beach Memorial Hospital, CareMore Health team up
Long Beach (Calif.) Memorial Medical Center and Cerritos, Calif.-based CareMore Health Plan teamed up to allow CareMore members access to the medical center's inpatient and outpatient services at in-network rates.

9. UnitedHealthcare, Moffitt Cancer Center partner for lung cancer payment model
Tampa, Fla.-based Moffitt Cancer Center and payer UnitedHealthcare launched a value-based payment model for lung cancer treatment effective Oct. 1.

10. Spartanburg Regional Health System, UnitedHealthcare renew agreement  
Spartanburg (S.C.) Regional Healthcare System and Minnetonka, Minn.-based UnitedHealthcare agreed to a two-year contract to keep all SRHS hospitals and physicians in UnitedHealthcare's network, effective Oct. 15.  

More articles about payer issues:
CMS green lights BCBS of Michigan's home model for Medicare Quality Payment Program
CDC: ACA effectiveness at lowering uninsured rate may be plateauing
Cigna retracts planned ACA exchange expansion in 3 states

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

 

Top 40 articles from the past 6 months