Anthem customers will pay more at CommonSpirit hospitals after contract fell through

A major insurer and a large hospital system failed to reach an agreement by their Tuesday deadline, meaning some Colorado patients will have to change doctors or prepare to pay more.

Anthem BlueCross BlueShield of Colorado and CommonSpirit Health, which owns 11 hospitals in the state, couldn’t reach an agreement to continue their contract because they disagreed on how much the insurer should pay for procedures. As of Wednesday, CommonSpirit is no longer in Anthem’s network, meaning Anthem-insured patients who go to any of its hospitals could be stuck paying the difference between the rates that Anthem pays and the prices that CommonSpirit charges. Depending on the service, the difference could be thousands of dollars, because federal and state laws only prohibit surprise bills for emergency care.

CommonSpirit, which owns the Catholic hospitals from the former Centura Health partnership, released a statement Wednesday morning saying that it had asked for a temporary contract extension while the sides continued to talk.

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“We continue to be engaged in good-faith negotiations,” the statement said.

Anthem said a short-term extension would only confuse its customers more and accused CommonSpirit of disrupting patients’ care as a bargaining technique.

“Anthem remains fully committed to reaching a collaborative, multi-year agreement with CommonSpirit (that) will give Anthem members the access to affordable healthcare that they deserve,” the insurer said in an email.

Patients who are pregnant or undergoing treatment for a complex condition, such as cancer, could continue receiving care from CommonSpirit providers, but would have to pay out-of-pocket and seek reimbursement from Anthem.

CommonSpirit accused Anthem of offering payments that wouldn’t cover the effects of inflation, while Anthem said CommonSpirit had asked for payments that were more than twice the inflation rate. Since negotiations aren’t public, patients have no way of verifying those claims.

In a statement Wednesday, Colorado Insurance Commissioner Michael Conway urged Anthem and CommonSpirit to continue negotiating. If they can’t reach a deal, the Division of Insurance said people in parts of the state without a nearby alternative hospital can reach out to Anthem for an exemption, particularly if weather prevents them from traveling.

“Consumers are the ones that are harmed when deals fall apart,” the statement said. “Anthem and CommonSpirit also must work together to be cognizant that increased health care costs are ultimately born by those same Coloradans.”

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