9 payer-provider contract disputes, resolutions in January

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

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1. OSF HealthCare still negotiating with payers ahead of Presence acquisition
Peoria, Ill.-based OSF HealthCare remains in negotiations with Blue Cross Blue Shield of Illinois and Health Alliance Medical Plans days before OSF’s acquisition of two hospitals owned by Chicago-based Presence Health.

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

3. 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.

4. 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.

5. 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.

6. Centura Health, Cigna reach contract impasse as deadline looms
Centennial, Colo.-based Centura Health may no longer be part of Cigna’s provider network if negotiations between the two parties falter.

7. 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.

8. 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.

9. 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.

More articles on payer issues:
OSF HealthCare still negotiating with payers ahead of Presence acquisition
Aetna’s executive vice president of consumer health and services to step down
Oscar Health: 66% of member interactions were virtual in 2017

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