Mercy announces new agreement with Anthem Blue Cross & Blue Shield

UPDATE 12/4/2024 — Just a few months after announcing a potential end to contracts with Anthem, Mercy says the two companies have reached a new agreement.

According to a release from Mercy, the health system and Anthem Blue Cross and Blue Shield have a new multi-year contract.

Under the new agreement, Anthem members covered by Anthem employer-based, Medicare Advantage and Affordable Care Act Marketplace plans in Missouri will have uninterrupted in-network access to Mercy doctors and care sites.

Healthy Blue has also reached a new agreement for Healthy Blue Medicaid plans, too. Those members will also have continued, uninterrupted care, Mercy says.

Original story:

MISSOURI — Mercy has announced its intent to end contracts with Anthem Blue Cross Blue Shield (BCBS) at the end of the year if the companies can't reach an agreement.

According to a press release from Mercy, the contracts that will end include all commercial, Medicare Advantage, Affordable Care Act (ACA) marketplace, managed Medicaid plans (Healthy Blue) and HealthLink (which falls under the Anthem BCBS umbrella).

Mercy says the move comes as an effort to "remove much of the red tape that makes it increasingly difficult for patients to navigate Anthem's system and creates a burden and barrier for patients to receive care when it's medically necessary."

Unless a new agreement can be reached, Mercy says it will move out of network as of Jan. 1, 2025. This notice does not impact Mercy retail pharmacy services which will allow Mercy Pharmacy's locations to continue serving Anthem patients with in-network coverage.

President of Croley Insurance and Financial, Trevor Croley, says this isn't the first or the last time contract negotiations have progressed to this point between hospitals and insurance companies.

"This is kind of a little bit of a game of chicken right now," Croley said.

Croley recommends having conversations with your provider now just in case.

"At this point I wouldn't panic, but I'd say, 'Hey, I need to pay attention to what's going on,'" Croley said. "This isn't on autopilot anymore."

"I highly doubt that the people are being considered as much as they should," said Springfield resident Shayla Stillings.

Stillings has been a member of Anthem Blue Cross Blue Shield for 13 years.

"It would be a struggle," Stillings said. "Switching to Cox if we had to. It's hard enough to get a doctor's appointment as it is."

She tells me she doesn't have the option of changing insurance because she is enrolled through her job.

"These technicalities disrupt patient care and, in some cases, can be life-threatening," said Dave Thompson, Mercy's senior vice president of population health and president of contracted revenue, in a statement. "They are administrative tasks dictated and mandated by Anthem, and they are a barrier to timely, appropriate patient care and can shift the cost of health care away from the insurance provider to those less able to afford it – our patients. Our patients have enough to worry about as they are often in the middle of a personal health care crisis. They shouldn't have to worry about whether their insurance company will approve their coverage. They should be able to solely focus on their health and the health of their family members."

The press release also says that while Mercy and other healthcare organizations are facing rising costs, managed care companies like Elevance Health (the corporate name for Anthem) are turning profits. According to Mercy, Elevance Health reported a 24.12% increase in income and a 24.29% increase in its net profit margin.