Mercy Health, Cigna reach agreement

Apr. 2—LIMA — Mercy Health has an agreement to keep Cigna commercial health insurance plans in its network, the hospital system announced Wednesday morning.

The health network and insurance company entered contract negotiations earlier this year to set hospital and other medical prices for Cigna commercial health insurance plans.

The two parties reached an agreement Tuesday following a 24-hour contract extension to avoid a lapse in coverage for the estimated 30,000 Ohioans insured through Cigna commercial insurance plans who visit Mercy Health providers, including Mercy Health-St. Rita's Medical Center in Lima.

"We believe that access to quality health care services is vital for our community members," said Dr. Matt Owens, chief clinical officer for Mercy Health-Lima, in a news release. "After several months of negotiations, we are pleased to have reached a new agreement that protects our patients' access to affordable, compassionate care close to home.

"Having access to the providers you know and trust is critical for the health of our community, and we are grateful to our patients who entrust us with their care. We look forward to serving you for years to come."

Health systems and insurance companies routinely negotiate prices for medical services, but patients are increasingly finding themselves at the center of those negotiations.

Mercy Health urged patients to contact Cigna while negotiations were underway this year, as the health system alleged Cigna had not provided a rate increase for six years in some markets.

Meanwhile, Cigna alleged the price increases Mercy Health wanted would "make healthcare unaffordable" for its customers.

The two parties last negotiated prices for employer-sponsored health insurance plans in 2022.

The disputes are often resolved without disruption in coverage, but patients can lose access to their doctors or pay higher out-of-network prices when a health system decides to stop accepting an insurance plan.

Nearly 50,000 Ohioans insured through Anthem-managed Medicaid insurance plans temporarily lost in-network access to Mercy Health hospitals and medical practices in Ohio two years ago, as the health system sought higher reimbursement rates from Anthem's commercial insurance plans.

The health system threated to terminate its contract with Anthem Medicare Advantage plans that same year, though the two parties reached an agreement before those patients lost coverage.

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