Covenant Health and Anthem resolve dispute affecting thousands of Mainers

One of Maine’s major insurers and a Catholic health care system with hospitals in the state reached an agreement Wednesday after months of negotiations that left about 14,000 patients with questions about the future of their health care.

Covenant Health, a family of Catholic health care organizations in New England and part of Pennsylvania, announced that it struck a “multi-year agreement” with insurer Anthem Blue Cross and Blue Shield. The contract will last through 2025, spokesperson Karen Sullivan said.

For patients who receive care through St. Joseph Healthcare in Bangor, St. Mary’s Health System in Lewiston and other Covenant facilities in Maine, the news means their visits will continue to be in-network. Patients would likely be faced with higher co-payments and other costs if the companies had not reached a resolution — expenses that not all Mainers can afford.

The agreement comes a day after the companies’ contract expired. On Monday, spokespeople from both companies said negotiations were ongoing and patients should prepare for Covenant Health providers and facilities to leave Anthem’s network, which would likely result in higher costs for care.

The agreement protects access to high-quality care for Mainers that is also affordable, said Denise McDonough, president of Anthem Blue Cross and Blue Shield in Maine, in a statement.

“We appreciate the patience Anthem members throughout Maine have shown during this process,” said Stephen J. Grubbs, Covenant Health president and CEO, in a statement. “We are confident the extra time we spent in discussions with Anthem helped ensure we have the resources necessary to provide Mainers with the highest quality care and best patient experience possible.”

 

Talks between the companies led them to realize they could streamline the claims process and reduce paperwork for providers and patients, Grubbs said.

 

 

Read More

Leave a Reply

Your email address will not be published.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