MercyHealth statement on insurance negotiations with Elevance Health
Bon Secours Mercy Health is an important and necessary pillar of the health care system in the communities we serve, and we are committed to providing high-quality, compassionate care in 1,200 care sites across seven states.
Mercy Health, as part of Bon Secours Mercy Health, contracts with health insurance companies (private payers), such as Elevance Health (Anthem), to fairly reimburse our organization for the cost of providing high-quality care to our patients. Our current contracts with Elevance Health (Anthem) have not kept pace with the rising cost of labor, supplies and drugs - undermining our ability to provide care now and into the future - and over the last nine months, we have been negotiating in good faith with Elevance Health (Anthem) to change that.
Health care organizations across the nation, including Mercy Health, have been experiencing significant inflationary, labor and supply cost challenges. Our labor costs have increased 9.6% while supply chain shortages and inflation have increased our operating expenses and overall cost of care by 6.8% from 2021 to 2022. It is critical that our patients have access to the care they need when they need it, and reimbursement to cover our costs is an important part of that equation.
We want to be good stewards of your health care dollar. In a recent Modern Healthcare article, it was noted that Elevance Health (Anthem) reported earnings of $2.8B in the first quarter of this year alone – a 16.6% year-over-year increase – all while owing Bon Secours Mercy Health more than $100M in late and unpaid claims.
We have been actively seeking resolution, especially knowing that Mercy Health is not the only one shouldering the burden of Elevance Health’s (Anthem) practices. Patients and employers often have lengthy delays before receiving clear explanation of their benefits and associated costs. This often results in patients receiving final statements months to years after services have been provided.
It is important that Elevance Health (Anthem) step up and support the care and well-being of its policyholders and the health care providers who care for them. We are doing our part to serve our patients and communities, and we need Elevance Health (Anthem) to step up now and do theirs by offering sustainable, market-equitable rates and fair contract terms.
We encourage patients to call Elevance Health (Anthem) at the number on the back of their insurance card to urge them to fulfill their responsibility and make patients and policyholders a priority. For more information, please visit www.mercy.com/elevancehealth to learn about your options and steps you can take to make your voice heard.
It’s unfortunate that this is the current situation; however, we promise to continue doing our part and work hard, in good faith, to reach a new agreement with Elevance Health (Anthem) with a clear understanding that it takes two parties working hand in hand to reach a resolution. Elevance Health (Anthem) has discontinued current negotiations, and while that is disappointing, we remain committed to compassionately serving every patient who walks through our doors.
Most imminently, for patients who are covered by Managed Medicaid plans with Elevance Health insurance, if we’re unable to reach a resolution by June 30, Mercy Health physician practices throughout Ohio, and Mercy Health hospitals in Cincinnati, Lima, Lorain, Springfield, Toledo and Youngstown, will no longer be considered in-network effective July 1. If patients have Managed Medicaid insurance through Elevance Health (Anthem) in Ohio, the health insurance company may start covering less, or none, of the care they receive at Mercy Health.
To understand how these changes could impact an individual patient, patients should contact Elevance Health (Anthem) directly at the Customer Service number located on the back of their insurance card to learn more about their specific health insurance benefits.
Currently only patients who have Elevance Health’s Managed Medicaid plan in Ohio could be impacted by this negotiation. All other patients with Elevance Health insurance are not impacted at this time but may become impacted soon. We ask that patients please continue to check back to our website as things change.
---------------------------------------------------------------------------------------
(EDITOR’S NOTE: Get the latest Mahoning Valley news in your email inbox weekday mornings. Sign up here for our free daily newsletter.)
-----------------------------------------------------------------------------------------
Here’s how you can support Mahoning Matters.
-----------------------------------------------------------------------------------------
Follow Mahoning Matters on Facebook, Twitter and LinkedIn.