(COLORADO) — The contract between CommonSpirit Health and Anthem Blue Cross Blue Shield (BCBS) expires on May 1, 2024, and unless negotiations for a new contract are completed by that deadline, the relationship between the two may come to an end, impacting thousands of patients.
According to both Anthem and CommonSpirit, negotiations to keep CommonSpirit facilities and physicians in-network with Anthem have been in progress for several months. However, Anthem is arguing that CommonSpirit’s reimbursement rates are double the rate of inflation, and some of the highest in the state of Colorado. As an example, Anthem said CommonSpirit’s emergency room rates at Front Range facilities are 45% higher than all other nearby health systems, and its mountain and rural facilities are 232% higher.
“If Anthem were to give in to CommonSpirit’s demands, it would dramatically increase out-of-pocket and premium costs for our members,” Anthem said in an announcement on its website.
CommonSpirit, which described itself as a nonprofit health system in its own announcement, said it is trying to reach an agreement that will safeguard patient care while also working to provide care for community members both in and out of the hospital.
“We need a contract that enables us to keep building more resilient communities, advocate for the poor and vulnerable, and innovate how and where health can happen—both inside our hospitals and in our communities,” CommonSpirit said.
What happens if an agreement cannot be reached?
Come May 1, if a new agreement is not reached, CommonSpirit facilities and physicians in Colorado will no longer be in-network for Anthem members. Click here for a full list of impacted facilities. Penrose, St. Mary Corwin, and St. Francis medical centers are all among the facilities impacted.
Patients who are currently in active treatment or who have appointments or procedures scheduled after May 1 may qualify for protected in-network access through Continuity of Care benefits from Anthem. Anthem said it would be reaching out to members who need continuity of care, specifically those with serious or complex conditions so they can continue their care at CommonSpirit facilities even if negotiations are not successful.
To stay up to date on the negotiation, Anthem encouraged members to stay tuned to its website, which can be found at the link above referencing impacted facilities.
