Here are the new payer contracts Becker’s has reported in 2023.
March
UnitedHealthcare and Cigna are back in network with Clovis, Calif.-based Community Health System. The four-hospital system went out of network with UnitedHealthcare, Cigna and Anthem Blue Cross at the end of 2022. The system remains out of network with Anthem Blue Cross as of March 7.
Oscar Health will keep CVS Caremark as its pharmaceutical benefit manager through 2026.
CareSource, a Dayton, Ohio-based managed care organization, is partnering with Walmart to tackle racial health inequities.The three-year agreement aims to create “innovative, evidence-based solutions to improve health outcomes in under-resourced and underserved communities where racial health inequities are widespread,” according to a CareSource news release.
February
Blue Cross and Blue Shield of Minnesota struck a value-based agreement with tech-enabled rural health startup Homeward that aims to close care delivery gaps.
ConnectiCare reached a new contract with Prospect Medical Holdings, the parent company of three Connecticut hospitals, avoiding a split that would have affected 6,500 beneficiaries.
Molina Healthcare is now in network with three Prime Healthcare hospitals in Texas — Mission (Texas) Regional Medical Center, Knapp Medical Center in Weslaco and Harlingen (Texas) Medical Center.
Blue Cross and Blue Shield of Oklahoma and Tulsa, Okla.-based Ascension St. John have reached a new contract agreement to keep BCBS members in-network at seven Oklahoma hospitals and medical centers.
Anthem Blue Cross Blue Shield avoided going out of network with Fredericksburg, Va.-based Mary Washington Healthcare as the sides were able to reach a new contract ahead of the March 1 split date.
Medical Mutual of Ohio and Kroger Health reached an agreement to provide in-network services to Medical Mutual’s Medicare Advantage members.
Centene and Springfield, Mo.-based Cox Health reached an agreement to keep Centene’s Medicaid beneficiaries in network.
BlueCross BlueShield of Tennessee reached a contract agreement with Methodist Le Bonheur Healthcare for plans covering Medicaid beneficiaries. The sides are continuing to negotiate a new contract regarding the insurer’s employer-based and marketplace plans.
Humana inked a five-year agreement with ChenMed to provide in-network services to Humana Medicare Advantage members.
Aetna was awarded a contract to continue managing West Virginia’s Medicaid services for children in the foster care system.
Blue Cross and Blue Shield of Oklahoma and Duncan, Okla.-based DRH Health have reached a two-year contract to keep the health system in network.
Cigna employer-sponsored health plans will remain in network with Phoenix Children’s Hospital while the sides finalize a new contract.
Cigna settled a long dispute with Houston-based St. Luke’s Health. The two organizations reached a new contract agreement set to begin March 1, bringing 66,000 patients back in network.
January
Blue Cross and Blue Shield of Texas and Ascension Texas reached a new contract agreement, avoiding going out of network in a dispute that could have affected 66,000 patients.
CVS Accountable Care Organization and Chicago-based Rush University System for Health are collaborating on ACO REACH participation for Medicare members in the Chicago area.
Blue Cross Blue Shield of Texas and Abilene, Texas-based Hendrick Health have extended their contract agreement through April 30, avoiding a split between the two organizations. The contract was set to expire Feb. 1.
Cigna of Ohio and Cincinnati-based Mercy Health reached an agreement to keep over 12,000 patients in network.
Horizon BCBS scored a contract extension to manage health insurance for New Jersey state employees, despite state officials and media reports alleging that previous contract terms have not been upheld by the payer. Horizon’s contract is worth about $136 million annually and provides health coverage to 600,000 state employees, retirees and their dependents.
Aetna and Munster, Ind.-based Community Healthcare System agreed to a contract extension, avoiding a split that would have left Aetna commercial and Medicare Advantage members out of network. The two sides agreed to extend their current contract through at least Oct. 1. The agreement was set to expire Jan. 15.
Aetna will manage health insurance for more than 740,000 North Carolina state employees, winning a contract BCBS North Carolina has held for over 40 years. State Treasurer Dale Folwell’s office rejected protests of the contract decision from BCBS North Carolina and UMR, a UnitedHealthcare subsidiary.
Source: BeckersPayer