Mercy Health, Anthem continue dispute about reimbursements

TOLEDO — Mercy Health may be out-of-network for Anthem Medicare Advantage patients in Ohio beginning Oct. 1 following months of negotiations with Elevance Health (Anthem) regarding reimbursement to the ministry for the cost of providing care.

Mercy Health said in a release Anthem’s reimbursements, are less than other payers, have not kept up with inflation and are inadequate to account for the cost of providing care.

The release said the change would impact all Ohio physician practices and most Mercy Health hospitals in Ohio.

However, hospitals in the Toledo market would remain in-network at that time due to a different contract termination date.

“Mercy Health has served the Toledo community, with emphasis on those who are underserved, for more than 165 years, and we strongly believe that all patients deserve access to high quality care with providers they trust,” said Bob Baxter, president of Mercy Health — Toledo, said in the release.

To plan for a possible Oct. 1 transition, the release said patients with Medicare Advantage insurance in Ohio can talk to their broker or call the Centers for Medicare and Medicaid Services at 800-633-4227 to explore options. Medicare Advantage Open Enrollment opens Oct. 15.