COLUMBUS — Patients at The Ohio State University Wexner Medical Center were notified that their coverage from Anthem Blue Cross Blue Shield insurance may be removed from the network on Jan. 1.
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135,000 patients received an email notifying them of the change on Wednesday, and while Ohio State and Anthem have until Dec. 31 to agree on a new contract, patients are wondering what that means for them, our news partners at WBNS-10 TV reported.
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Thea Flittner, a Type 1 diabetic who received care at Ohio State during her high-risk pregnancy with her now 1-year-old daughter, said it is important to have a trusted medical team and is uneasy after receiving the email on Wednesday.
“You feel really uncertain because all of a sudden you are left wondering do I need to find new medical care? If we were to have another pregnancy what would my medical care look like and who would I go to?” Flittner said.
Representatives for Anthem and Ohio State said they are optimistic they will reach a deal by the deadline, but in statements obtained by WBNS-10 TV, each party places blame on the other for the lack of agreement so far.
“However, we are concerned that OSU wants to increase its prices for patients and their employers at rates three times higher than inflation. These price hikes would increase healthcare costs for Central Ohio by $185 million over the next three years. Ohio’s consumers and employers who would pay these cost increases cannot afford these extreme price hikes,” said Anthem spokesman Jeff Blunt.
Ohio State has disputed the claim.
“Anthem has underpaid us for the past few years, failing to keep pace with inflation,” said a representative for Ohio State. “While Anthem consistently raises employer and member premiums, they have not invested into patient care at the same rate. Our costs to deliver care have risen 45% in the last five years, and, unlike other insurance providers, Anthem has refused to consider appropriate rate adjustments so the health care providers their members trust can cover expenses.”
Ohio State added: “We are the region’s only nationally ranked medical center and NCI-designated comprehensive cancer center – and we want to remain in Anthem’s insurance networks.”
In the email sent Wednesday, patients were advised not to cancel their appointments, Is also said patients with certain conditions may qualify for continuity of care to receive care after the contract ends.
In November, it was announced that Ohio State would no longer be in network for patients of ANthem’s Medicare Advantage plan in 2025.
This situation is not unique to OSU and Anthem. Mount Carmel and Aetna are going through similar contract negotiations, according to WBNS-10 TV.
In a statement, Mount Carmel said in part: “Our payments from Aetna have not kept pace with the rising costs to provide outstanding care. At the same time, Aetna keeps raising premiums and out-of-pocket costs for its members, to boost their profits, which topped $5.6 billion in 2023. We are asking Aetna to put patient health over their wealth.”
Aetna said in a statement: “We are continuing our discussions with Mount Carmel Health System in hopes of reaching a new agreement. We remain far apart on terms and while we want to reach an agreement that keeps them in our network, we cannot agree to terms that would burden our members and local employers with significant cost increases.”
If Mount Carmel and Aetna cannot also come to an agreement by Dec. 31, Mount Carmel will no longer be in Aetna’s network in 2025. This would impact patients on commercial and Medicare plans.
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