ST. LOUIS – Mercy and Anthem Blue Cross and Blue Shield in Missouri (Anthem) have reached a new multi-year agreement providing Anthem members with health care at all Mercy hospitals, outpatient care centers and physician offices across Missouri.
Missouri Care, Inc - doing business as Healthy Blue - has reached an agreement for the Healthy Blue Medicaid plans as well. Healthy Blue members will have continued uninterrupted in-network access to Mercy doctors and care sites.
Back in September, Mercy, one of the largest healthcare providers in Missouri, announced they were planning to end their contract with the insurance company at the end of 2024.
September 2024
Officials with Mercy said earlier this year that the decision came out of concerns for their patients financially.
“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,” said Dave Thompson, Mercy’s senior vice president of population health and president of contracted revenue, in a press release. “We know this news will be concerning for hundreds of thousands of Mercy patients with Anthem BCBS. We will continue to negotiate in good faith with Anthem in hopes of avoiding any disruption to our patients at the end of the year – particularly those patients in need of prolonged, coordinated care. However, patients and employers considering which health plans to purchase for 2025 should consider whether Mercy, the largest health system in the state, will be in the plan they purchase.”
Mercy points to June 2024, when Elevance Health (the corporate name for Anthem) reported an increase of over 24% in its year-over-year net income (valued at $2.3 billion). They also say Elevance Health also increased over 24% in its year-over-year net profit margin.
Mercy boasts lower average cost for patients compared to other hospitals in state (27% less for commercially insured inpatients, 16% less for outpatients). Over $500 million in free care was made available in the 2023 fiscal year by Mercy. The free care includes traditional charity care, un-reimbursed Medicaid, and other community benefits.
Anthem provided Spectrum News with a statement (from September) about Mercy's decision.
"Mercy has informed us that if we do not agree to their drastic price demands, they will leave our health plans starting January 1, 2025," said Emily Snooks, the media contact for Anthem. "Over the next two years, Mercy wants to increase the prices they charge our members and employers by five times the current inflation rate. Mercy has also demanded contract language that would keep specialty medications unnecessarily expensive when lower cost options are available. Anthem has offered reasonable payment increases in excess of the consumer price index for each of the next two years and we continue working hard to reach an agreement."