Ongoing conflict between Mercy Health and Anthem could affect more than 15,000 people in local community | News, Sports, Jobs

WARREN — On Oct. 1, Bonn Security Mercy Health hospitals and doctors were removed from a network of nearly 15,000 Youngstown-area Medicare Advantage patients enrolled in the Anthem Blue Cross Blue Shield. there may be.

The health care system announced on Thursday that talks are continuing between the parties over Anthem’s reimbursement, but Von Securities Mercy Health said paying for quality care “has not kept up with inflation and is overwhelmingly inadequate.” Enough,” he argues.

The release said Mercy Health, like other healthcare providers, is experiencing “significant inflation, labor and supply cost issues,” leading to operating losses despite curtailing operations. It is also said that there are

Dr. John Luellen, president of Mercy Health Lorraine and Youngstown, said in a release that it was “unconscionable” for Anthem to record record profits while refusing to fully reimburse them for their treatment. Ta.

Anthem last month reported operating revenue of $43.4 billion, up 12.7% from a year earlier, according to Mercy Health.

Anthem spokesman Jeff Blount said in an email that Mercy Health will continue to work with Anthem Medicaid and Medicare Advantage to enforce mid-contract cost increases for employers and members covered by the Affordable Care Act. said it had terminated its contract early.

The deal, which expires on January 1 and includes annual increases to account for inflation and rising labor costs, Mercy Health said, “is now asking for an increase of three times the current rate of inflation. ‘ said Brandt.

“I plead with Ansem to return to the negotiating table to resolve this issue,” Mr. Luren said.

“We have repeatedly asked Mercy Health to reverse this termination and protect Medicare Advantage and Medicaid members in disputes over pricing in disparate lines of business,” Brandt said.

“They needlessly interfere with the care of thousands of vulnerable people as a bargaining tactic to force high rates on employers and those subject to the Affordable Care Act.” Mr Brandt said.

A Mercy Health release states that Anthem “consistently chooses shareholder value over patient care.”

Medicare is federal health insurance for everyone over the age of 65 and some people under the age of 65 with certain disabilities and conditions.

Medicare Advantage, also known as Part C, is different from original Medicare. Advantage plans are not government-controlled, and Medicare Advantage is a Medicare-approved plan by a private insurance company as an alternative to the original plan.

Advantage plans include hospital and medical insurance, and usually include prescription drug coverage.

The disagreement is the latest between the Cincinnati-based health care system and Indianapolis-based Anthem.

A lingering contract dispute over fees for Anthem-administered Medicaid recipients prompted Mercy Health to set a cut-off date of July 1, after which Mercy Health doctors and facilities were removed from those patients’ networks. .

Mercy Health likewise argued that it needed higher rates because it was experiencing inflation, labor costs and rising supply costs.

But Anthem said Mercy Health’s rate of interest was more than double the rate of hospital inflation, accusing Mercy of trying to take advantage of higher rates from non-Medicaid members by terminating Medicaid membership.

About 3,500 people were affected in the Mahoning Valley.

Get today’s breaking news and more right in your inbox

Source link

Leave a Reply

Your email address will not be published. Required fields are marked *