16 payer, provider contract disputes, resolutions

Here are 16 contract resolutions and dissolutions that occurred between payers and providers in the past month, beginning with the most recent.

1. Affinity Health resolves agreement with Cigna
Monroe, La.-based Affinity Health Group and Cigna reached an in-network agreement effective immediately.

2. Blue Shield, NorthBay Healthcare spar over contract issues
NorthBay Healthcare in Fairfield, Calif., and Blue Shield of California are poised to terminate their in-network agreement Dec. 1. 

3. Humana drops Greenville Health System from Medicare network
Louisville, Ky.-based Humana severed ties with Greenville (S.C.) Health System for its Medicare Advantage health maintenance organization plan.

4. Tufts Health Plan, Steward Health terminate their Medicare agreement
Watertown, Mass.-based Tufts Health Plan and Steward Health Care System in Boston plan to terminate their Medicare Advantage agreement Dec. 31.

5. Geisinger, Meridian scrap Medicare Advantage plan
Geisinger Health Plan and Hackensack Meridian Health ended a four-year collaboration on their Medicare Advantage plan — Geisinger Gold.

6. Yale Medicine, Anthem reach contract agreement
Anthem Blue Cross Blue Shield and Yale Medicine in New Haven, Conn., reached a multiyear contract agreement two days before their existing contract expired.

7. CHI Memorial Hospital, UnitedHealthcare sever ties
CHIMemorialHospital in Chattanooga, Tenn., notified affiliated providers it failed to negotiate a new contract with UnitedHealthcare.

8. Tenet Healthcare cuts ties with Humana
Dallas-based Tenet Healthcare dropped Humana health insurance plans following failed contract negotiations.

9. Aetna links up with Baptist Health, St. Vincent's HealthCare for value-based plan
Health insurer Aetna teamed up with Jacksonville, Fla.-based providers Baptist Health and St. Vincent's HealthCare for a value-based benefit plan aimed at improving quality and cutting costs.

10. Saint Mary's, Health Plan of Nevada tussle over Medicaid payments
Saint Mary's Health Network in Reno, Nev., may sever ties with Health Plan of Nevada following Medicaid reimbursement disagreements.

11. UnitedHealthcare, University of California launch 10-year value-based relationship
UnitedHealthcare teamed up with University of California in a 10-year value-based partnership.

12. BlueCross BlueShield, Catholic Health System launch tiered health plan
BlueCross BlueShield of Western New York and Catholic Health System in Buffalo, N.Y., partnered to offer individuals and small employers a tiered network plan. 

13. Providence Health & Services and Premera Blue Cross reinstate contract
Providence Health & Services and health insurer Premera Blue Cross renewed their in-network contract agreement.

14. Penn State Health St. Joseph to accept Geisinger health plans
Geisinger Health Plan policyholders can seek treatment for in-network prices at Reading, Pa.-based Penn State Health St. Joseph effective Oct. 1.

15. Nemours, UnitedHealthcare ink agreement amid ongoing lawsuit
After a two-year hiatus, NemoursAlfredI.duPontHospital for Children in Wilmington, Del., and UnitedHealthcare of Delaware reached a network agreement. The contract will not affect Nemours' ongoing lawsuit against the insurer over unpaid medical bills.

16. Southwest General, Anthem BCBS ink bundled payment contract
SouthwestGeneralHealthCenter in Middleburg, Ohio, and Anthem Blue Cross Blue Shield of Ohio implemented a bundled payment contract for total joint replacement surgeries.

More articles on payer issues, revenue cycle management: 

Saint Mary's, Health Plan of Nevada tussle over Medicaid payments
Affinity Health resolves agreement with Cigna
Geisinger, Meridian scrap Medicare Advantage plan

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