In an unexpected move, Mercy has announced the termination of its contract with Anthem Blue Cross Blue Shield, a decision that will impact its Missouri customers. The termination includes all commercial Medicare Advantage, Affordable Care Act (ACA) marketplace, managed Medicaid plans (Healthy Blue), and HealthLink, which falls under the Anthem BCBS umbrella.

Dave Thompson, Mercy's senior vice president of population health and president of contracted revenue, expressed his concern for the patients affected by this decision, stating, "Our focus remains on safeguarding our patients and ensuring they receive the low-cost, high-quality care they deserve with insurance coverage that provides the greatest amount of protection for their health."

While negotiations are ongoing, Mercy hopes to address the obstacles faced by patients when navigating Anthem's system. Thompson stressed that such technicalities create unnecessary burdens and barriers, ultimately disrupting patient care and jeopardizing their well-being.

Anthem Blue Cross and Blue Shield representatives responded to the announcement, stating that they are actively working with Mercy to find a resolution. However, Mercy has raised concerns regarding Anthem's proposed price demands and contract language, requesting a significant increase in prices charged to their members and employer groups.

Anthem has offered reasonable payment increases that exceed the consumer price index for the next two years. Nevertheless, the negotiation process continues as both parties strive to reach a mutually beneficial agreement.

For now, Mercy will remain in-network for medical services with Anthem until the end of the year. However, starting January 1, 2025, Mercy will move out of network unless a new agreement is reached. It is crucial for patients and employers to consider whether Mercy's services will be covered in their health plans for 2025, as Mercy is the largest health system in the state.

Mercy Pharmacy's retail locations will not be impacted by this change, ensuring continued service to Anthem patients with their current in-network coverage.

"We're innovating to improve access to care while achieving top performance in quality and safety. We are also keeping our costs significantly lower than other health systems," emphasized Thompson, highlighting Mercy's commitment to providing affordable and effective care.

Mercy encourages its patients to contact Anthem directly using the number on the back of their health cards to voice their concerns and share their experiences. The health system hopes that by involving patients, Anthem will recognize the critical need for changes in their policies and administration processes.

As the negotiations progress, the fate of Mercy's contract with Anthem Blue Cross Blue Shield remains uncertain. Both healthcare providers and customers alike are eagerly awaiting a resolution that prioritizes affordable, accessible, and high-quality care for all Missouri residents.