5 payer-provider disputes, resolutions

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

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1. Mission Health, BCBS end nearly 6-month spat with new contract: 3 things to know
Asheville, N.C.-based Mission Health System rejoined Blue Cross and Blue Shield of North Carolina’s provider network, effective Dec. 15. 

2. Montefiore Health System goes out of network with UnitedHealthcare’s Medicare Advantage plan
Bronx, N.Y.-based Montefiore Health System will go out of network with UnitedHealthcare’s Medicare Advantage plans Dec. 31.

3. Iora Health physicians join UnitedHealthcare’s Medicare Advantage network
UnitedHealthcare added Iora Health’s Hanover, N.H.-based Dartmouth Health Connect primary care physicians to its provider network.  

4. Anthem joins Colorado’s Medicaid alliance
Anthem entered the Colorado Community Health Alliance, a care model integrating behavioral and physical healthcare for Medicaid beneficiaries. 

5. New Jersey hospital files motion against Horizon BCBS over tier placement
New Brunswick, N.J.-based Saint Peter’s University Hospital filed a motion to supplement its complaint against Horizon Blue Cross Blue Shield of New Jersey’s tiered provider network.

More articles on payer issues:
Montefiore Health System goes out of network with UnitedHealthcare’s Medicare Advantage plan
UnitedHealthcare unveils value-based Medicare Advantage program with Oak Street Health
Fitch: CVS Health-Aetna ‘prime example’ of healthcare’s focus on pricing power

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