Valley Health chief still optimistic about Anthem contract renewal

The Winchester-based health system's existing contract with the health insurance provider expires in less than two months on Dec. 31.

If no agreement is reached, approximately 55,000 Anthem customers who seek care annually at Valley Health facilities would be out-of-network with the health care provider at the beginning of 2024.

Valley Health, which serves a population of about 500,000 people in the region, is parent company of Winchester Medical Center and five other hospitals in the region, in addition to more than 60 medical practices and Urgent Care centers, as well as other health care facilities. Operational statistics for the 2022 calendar year include 29,000 hospital admissions, 140,000 emergency department visits and 17,000 surgical cases.

At the Valley Health Corporation meeting Tuesday at the George Washington Hotel in Winchester, Nantz gave a brief update on the negotiations.

"We had a lawsuit earlier this year," Nantz said, referring to Valley Health's multi-million lawsuit against the health insurance provider over past due payments, which was resolved for an undisclosed amount earlier this year. "We settled that lawsuit, and we began negotiating in good faith in July, and while I can't tell you that we have everything tucked away and have a deal done yet, they are negotiating in good faith, and we are negotiating in good faith, which leads me to believe we should come to an arrangement."

He continued: "We are making progress, and I think they could tell you that as well. I'm very hopeful that we will get that taken care of, and we can announce something in the coming month before the end of the contract."

In October 2022, Valley Health sued Anthem to recoup $11.4 million in past due payments. Though initially filed in Winchester Circuit Court, the suit advanced to federal court and increased to $15 million. In April, the two parties reached a settlement.

At a Valley Health System Corporation meeting in May, Nantz updated stakeholders on the recently resolved lawsuit and said he was "very optimistic" about 2024 contract negotiations.

This marked a major improvement from January, when Nantz announced that the two parties remained in a "severe disagreement" over the claims dispute. At the time, he said the court case would likely extend into 2024, past the end-of-year contract deadline.

In 2020, Valley Health came close to breaking ties with Anthem over reimbursement negotiations, but the contract between the two parties was renewed.