92 payer-provider disputes, agreements in 2017

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Becker's Hospital Review reported these 92 contract resolutions and dissolutions between payers and providers this year, beginning with the most recent.   

  1. New Hyde Park, N.Y.-based Northwell Health signed an agreement with Cigna to maintain their 20-year network relationship.

  2. Fishersville, Va.-based Augusta Health has yet to finalize a deal with Anthem BlueCross BlueShield.

  3. Asheville, N.C.-based Mission Health System rejoined Blue Cross and Blue Shield of North Carolina's provider network, effective Dec. 15. 

  4. Bronx, N.Y.-based Montefiore Health System will go out of network with UnitedHealthcare's Medicare Advantage plans Dec. 31.

  5. UnitedHealthcare added Iora Health's Hanover, N.H.-based Dartmouth Health Connect primary care physicians to its provider network.  

  6. Anthem entered the Colorado Community Health Alliance, a care model integrating behavioral and physical healthcare for Medicaid beneficiaries.
  7. 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.

  8. Tacoma, Wash.-based CHI Franciscan Health and Humana collaborated on a value-based care payment model for the payer's Medicare Advantage members in Washington state.

  9. Peoria, Ill.-based OSF HealthCare signed an in-network agreement with Blue Cross and Blue Shield of Illinois Nov. 22.

  10. West Des Moines, Iowa-based UnityPoint Health notified about 54,000 patients it may end its contract with Amerigroup of Iowa, one of two insurers managing Medicaid coverage in the state. 

  11. Cincinnati-based Mercy Health's The Jewish Hospital-Mercy Health, located in a Cincinnati suburb, joined Anthem's Medicare Advantage provider network.

  12. Blue Cross and Blue Shield of Texas members gained in-network access to Amarillo-based Northwest Texas Health System facilities under a new contract.

  13. Vancouver, Wash.-based PeaceHealth and Kaiser Permanente Northwest collaborated on healthcare delivery and coverage in Lane County, Ore.

  14. Cleveland Clinic and CareSource agreed to a long-term contract.

  15. Four rural Oklahoma hospitals sued Blue Cross Blue Shield of Oklahoma for allegedly breaching contract amid an ongoing rate dispute.

  1. Piedmont Healthcare in Atlanta will offer Kaiser Permanente health plan members in-network access to all facilities under a new contract.

  2. Charlottesville-based University of Virginia Health System unveiled a Medicare Advantage plan with Aetna Oct. 25.

  3. Boulder (Colo.) Medical Center and Humana launched a value-based healthcare delivery model for Humana Medicare Advantage policyholders in Colorado.

  4. Anthem Blue Cross and Blue Shield in Ohio added University of Cincinnati Medical Center to its Medicare Advantage provider network.

  1. Nashville, Tenn.-based Vanderbilt University Medical Center signed an agreement granting in-network status to Cigna policyholders buying coverage on the 2018 ACA exchange. 

  1. Cleveland Clinic linked up with Anthem Blue Cross and Blue Shield in Ohio to offer a Medicare Advantage plan.

  2. Tower Health in West Reading, Pa. — formerly Reading Health System — and Independence Blue Cross inkeda three-year contract.

  1. Two Boston-based Iora Health primary care practices joined Humana's Medicare Advantage network in Arizona.

  1. Humana added Community Care Physicians in Latham, N.Y., to its value-based Medicare Advantage network. 

  1. Detroit Medical Center and Blue Cross Blue Shield of Michigan will collaborate on a value-based reimbursement model for the eight-hospital system. 

  1. Members of Aetna will maintain in-network access to Hartford (Conn.) HealthCare after the payer and provider renewed a contract set to expire in three months.

  1. Sioux Falls, S.D.-based Sanford Health and HealthPartners, a health plan managing government insurance, will launch Medicare plans in North Dakota and South Dakota effective Jan. 1.

  1. Cleveland Clinic and Humana created two Medicare Advantage plans for patients in Ohio's Cuyahoga County. 

  2. Abilene, Texas-based Hendrick Health System is disputing its contract with Blue Cross Blue Shield of Texas.

  1. Vanderbilt Health Affiliated Network, a Nashville, Tenn.-based organization of physicians, health systems and employers, rolled out an accountable care product with Aetna.  

  1. Medical Group of Pennsylvania in Harrisburg will participate in Highmark Blue Shield's value-based reimbursement model. 

  1. Rochester, Minn.-based Mayo Clinic Health System providers in Wisconsin and Minnesota are now considered in-network for Security Health Plan policyholders.

  1. New Orleans-based Ochsner Health System and Blue Cross and Blue Shield of Louisiana partnered to provide a joint health plan.

  1. Jersey City, N.J.-based CarePoint Health and Horizon Blue Cross Blue Shield resolved a more than 2-year-old contract dispute and $76 million lawsuit over billing.

  2. Managed care company WellCare of North Carolina, a subsidiary of WellCare Health Plans, added Mission Health System to its provider network Aug. 28. 

  3. Oklahoma City-based Integris Health and Blue Cross and Blue Shield of Oklahoma eluded an Aug. 31 contract termination. 

  4. Fountain Valley, Calif.-based MemorialCare Health System reached a definitive agreement to network with Anthem Blue Cross after cutting ties Aug. 15.

  5. Chambersburg, Pa.-based Summit Health and Humana contracted to allow Humana's Medicare customers in-network access to Summit Health's facilities and providers. 

  6. Annapolis, Md.-based Anne Arundel Medical Center and CareFirst BlueCross BlueShield inked a three-year in-network contract Aug. 4.

  7. Kingston, N.Y.-based HealthAlliance of the Hudson Valley and Empire BlueCross BlueShield resolved a dispute ongoing since May 2016.

  8. Mission Health System and Aetna inked a multiyear contract effective Oct. 1. 

  9. Vanderbilt University Medical Center and UnitedHealthcare negotiated an in-network agreement.

  10. Medical Mutual of Ohio SuperMed members gained in-network access to all Cleveland-based University Hospitals facilities and providers for the first time in 20 years. 

  11. Renaissance Physicians Organization entered a risk-based contract with Amerigroup, covering individuals with an Amerigroup Medicare Advantage plan in the Houston area.

  12. Mission Health System and Cigna inked a multiyear contract effective Sept. 1.

  13. Cleveland Clinic-affiliated Ashtabula (Ohio) County Medical Center extended its agreement with CareSource.

  14. Edgewood, Ky.-based St. Elizabeth Healthcare and WellCare entered a value-based care contract to improve health outcomes of Medicaid and Medicare beneficiaries.
  15. Missouri Care, part of WellCare, signed a contract with St. Louis-based SSM Health including in-network access for Missouri Care's HealthNet managed care members. 

  16. St. Charles, Mo.-based Mercy patients with health insurance through Anthem will be able to access Mercy providers at in-network prices beginning Jan. 1, 2018.

  17. Mississippi Affiliated Health Network, a 13-hospital physician-led network in Jackson, aligned with Aetna for an integrated care delivery model.

  18. Minneapolis-based Children's Minnesota and Blue Cross and Blue Shield of Minnesota reached a deal July 7, saving 66,000 patients from paying out-of-network rates.

  19. Four hospitals recently acquired by Harrisburg, Pa.-based PinnacleHealth from Franklin, Tenn.-based Community Heath Systems will stay in Capital BlueCross' provider network. 

  20. CHI Health and Blue Cross and Blue Shield of Nebraska, both based in Omaha, struck a three-year agreement on reimbursement rates.

  21. St. Paul, Minn.-based Gillette Children's Specialty Healthcare and Blue Cross and Blue Shield of Minnesota struck a three-year contract extension.

  22. Midland (Texas) Memorial Hospital and Aetna will continue in-network access for Aetna members at Midland Memorial facilities.

  23. UnitedHealthcare and University of Chicago Medicine reached an agreement to keep the medical center and its physicians in the insurer's network.

  24. Saint Francis Muskogee (Okla.) and Blue Cross Blue Shield of Oklahoma are back in network after terminating their interim in-network agreement June 1.

  25. Varnville, S.C.-based Hampton Regional Medical Center inked a network contract with UnitedHealthcare.

  26. Cleveland Clinic will offer a joint health plan with Oscar Health, marking the clinic's entrance into the health insurance market and Oscar's expansion into Ohio.  

  27. Sacramento, Calif.-based Sutter Health and Aetna will offer a jointly-owned health plan to residents in Northern California next year.

  28. St. Petersburg, Fla.-based Johns Hopkins All Children's Hospital is back in network with UnitedHealthcare following the termination of their contract May 11.

  29. King of Prussia, Pa.-based Recovery Centers of America, a provider of addiction treatment services, inked a coverage agreement with Blue Cross Blue Shield of Massachusetts for its Danvers, Mass.-based Boston Center for Addiction Treatment. 

  30. Dayton, Ohio-based Premier Health and Anthem Blue Cross and Blue Shield signed a value-based contract for services offered in the state's Miami Valley.

  31. Dallas-based Tenet Healthcare and Humana amended their multiyear provider network agreement June 1.
  32. Huntingdon Valley, Pa.-based Holy Redeemer Health System and Independence Blue Cross inked a three-year agreement to maintain in-network services at the health system for Independence policyholders. 

  33. Tupelo-based North Mississippi Health Services signed a three-year contract with UnitedHealthcare before the parties' temporary agreement expired May 31.

  34. Carrollton, Mo.-based Carroll County Memorial Hospital and Anthem Blue Cross and Blue Shield of Kentucky extended their network agreement to include the insurer's health maintenance organization and preferred provider organization plans.

  35. Memphis, Tenn.-based Saint Francis Healthcare and Humana inked a provider network agreement after going out of network with each other in October 2016. 

  36. San Francisco-based Dignity Health's Arizona hospitals are no longer in Woodland Hills, Calif.-based Health Net's network following unresolved disputes about reimbursement rates.

  37. Huntsville (Ala.) Hospital Health System extended its relationship with UnitedHealthcare to include Medicare Advantage policyholders.

  38. Tucson, Ariz.-based Northwest Healthcare reached a network agreement with UnitedHealthcare. 

  39. Memphis, Tenn.-based Baptist Memorial Health Care Corp. will replace Memphis-based Methodist Le Bonheur Healthcare as an in-network hospital in BlueCross BlueShield of Tennessee's Network S. 
  40. Hartford HealthCare and UnitedHealthcare signed a two-year provider network agreement.

  41. West Orange, N.J.-based RWJBarnabas Health and Aetna signed an agreement to continue in-network care for Aetna members at RWJBarnabas hospitals and physician facilities.

  42. Little Rock, Ark.-based CHI St. Vincent, part of Englewood, Colo.-based Catholic Health Initiatives, settled a contract dispute with UnitedHealthcare.

  43. Independence Blue Cross and Philadelphia-based University of Pennsylvania Health System contracted to share responsibility for quality and care costs.

  44. Vanderbilt Health Affiliated Network and Humana entered a four-year value-based agreement.

  45. Anthem BlueCross BlueShield in Colorado and Centennial, Colo.-based Centura Health reached a contract agreement March 30.

  46. Philadelphia-based Temple University Health System and Independence Blue Cross agreed to extend their contract 18 months, effective at the beginning of 2017.

  47. Grand Island, Neb.-based CHI Health, part of Englewood, Colo.-based Catholic Health Initiatives, entered Blue Cross Blue Shield of Nebraska's Medicare Advantage network April 1.

  48. Chickasha, Okla.-based Grady Memorial Hospital reached a preferred provider organization agreement with Blue Cross and Blue Shield of Oklahoma.

  49. Idaho Falls-based Eastern Idaho Regional Medical Center and Blue Cross of Idaho signed a contract in March to provide in-network coverage to certain BCBSI policyholders seeking emergency and referred services at the medical center.

  50. Tenet Healthcare inked a multiyear contract with Blue Cross and Blue Shield of Texas ahead of the agreement's April 15 termination date. 

  1. Memphis, Tenn.-based Methodist Le Bonheur Healthcare and Humana inked an agreement to allow the insurer's Medicare Advantage members to access the health system at in-network rates.

  2. Ontario, Calif.-based Prime Healthcare Services will remain in-network with Anthem Blue Cross after backtracking on plans to end its contract with the insurer hours after the decision was publicized.

  3. Blue Cross and Blue Shield of Minnesota reached a separate contract with each of Duluth, Minn.-based Integrity Health Network's 20 affiliated clinics, avoiding the clinics' scheduled Feb. 1 exit from the insurer's provider network.

  4. Priority Health and Flint, Mich.-based McLaren Health Care agreed to add McLaren hospitals and physicians to Priority Health's network.

  5. Atlanta-based Grady Health System and Aetna agreed to a new contract to keep all Grady hospitals and physicians in Aetna's network. 

  6. Aetna and a physicians group at the University of Maryland in College Park agreed to coordinate patient care to enhance patient outcomes while reducing healthcare expenses. 

  7. BlueCross BlueShield of Western New York and Roswell Park Cancer Institute in Buffalo, N.Y., reached a three-year agreement to continue in-network access to the institute and its affiliated physicians for the insurer's policyholders.

  8. Boca Raton (Fla.) Regional Hospital and Humana renewed their contract, allowing Humana policyholders to access the hospital's services at discounted rates.

  9. Blue Cross and Blue Shield of Florida networked with Retreat Premier Addiction Treatment Centers in Palm Springs, Fla., to provide policyholders access to addiction treatment services.  

    More articles on payer issues:
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    4 health systems that shut down health plans in 2017

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