Another major insurer hits contract wall with WakeMed. What it may mean for patients. [The News & Observer (Raleigh)]

WakeMed will be out-of-network for people with Cigna health insurance next month if the two parties do not reach a contract agreement, the insurance company warned members in a letter this month.

If the contract lapses on Jan. 1, WakeMed hospitals, outpatient clinics and outpatient surgery centers will no longer be considered in-network for those on Cigna’s commercial plans. Out-of-network services are often associated with more expensive out-of-pocket costs for patients.

WakeMed Primary Care physicians would remain in-network as they have a separate contract with Cigna.

Kristin Kelly, spokesperson for WakeMed, said Cigna has been unwilling to agree to a contract with “fair and equitable” reimbursement rates for the hospital.

“The well-being of our patients and the community we serve will always be our priority,” Kelly said. “These negotiations are about much more than just finances, including their processes that put an unfair burden on our patients.”

Cigna said it has not yet been able to come to an agreement that keeps health care affordable but will “keep talking to WakeMed” to reach a resolution.

“It’s important to understand who pays the bills: any increase in cost of care is paid directly by local employers, their employees and families,” a spokesperson for the insurance company wrote in a statement.

This is just the most recent contract dispute between Triangle hospitals and large insurers.

In October, UNC Health and UnitedHealthcare publicly feuded over their contract. Later that month WakeMed and Humana had a similar dispute. Both are still unresolved.

Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

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