Mercy Health, Cigna reach agreement to keep patients in network

Apr. 2—The hospital system Mercy Health announced a multi-year agreement with the health insurer Cigna to keep its members on employer-funded health plans in network at Mercy Health's locations.

"After several months of negotiations, we are pleased to announce a new agreement that ensures our patients' access to affordable, compassionate care close to home," said Dr. Leonardo Lozada, Mercy Health Chief Clinical Officer-Cincinnati.

Mercy Health, which has locations in Springfield, Urbana and southern Butler County, is one of the largest health systems in Ohio.

This new agreement with Cigna keeps all Mercy Health physician practices, acute care hospitals, urgent care centers, ambulatory surgical centers and additional care sites in-network for the commercial insurance plans, the announcement from Mercy Health said.

"Having access to the providers you know and trust is essential 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," Lozada said.

A breakdown in negotiations was first announced mid-February when Mercy Health warned patients on employer-sponsored Cigna plans they may lose in-network insurance coverage after negotiations on reimbursements soured following months of effort.

Mercy Health and Cigna debated the reimbursement costs with a Cigna spokesperson saying Mercy Health was "demanding unreasonable rate hikes" for its employer-sponsored plans.

Almost all of Cigna's employer clients' benefit plans are self-funded, which means increases in the cost of care are paid directly by local employers, their employees and their families, a Cigna spokesperson said.

In some key markets, Cigna has not provided a rate increase in six years, according to Mercy Health. Cigna also has high rates of claim denials, which have led to significant delays in life-sustaining care and created operational challenges to efficient patient care, Mercy Health said.

Mercy Health later announced it had started to reschedule certain patients who might have been affected by the change in order to prevent disruption in their continuity of care.

Mercy Health aims to have long-term agreements with all major payers in order for patients to have seamless access to care, Mercy Health said.

"We understand that the possibility of Mercy Health being out of network with Cigna has been difficult, and we want to express heartfelt gratitude to our patients for their grace and support as we diligently worked through these negotiations," Mercy Health said in an organizational statement.

More information can be found at www.mercy.com/cigna-updates.

This news outlet has reached out to Cigna for comment.

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