Augusta Health Releases More Information on Contract with Anthem

Posted: Updated: Oct 05, 2017 05:37 PM

Negotiations have slowed between Augusta Health and the insurance company, Anthem Blue Cross Blue Shield.

At the end of 2017, Augusta Health facilities could be considered out of network for Anthem customers, if they do not agree on a contract.

Augusta Health's contract with Anthem expires on December 31. The hospital says it has made repeated efforts the past few months to find common ground with Anthem for fair pay.

Augusta Health says for years Anthem has paid employed physicians significantly less than other providers in the region.

It says these low payments are not sustainable.

If Augusta Health is not in Anthem's network, patients will have to drive at least 30 minutes outside of the region to get in-network care.

"If the impasse is not cleared, that we will go out of network effective January first 2018. We were very encouraged by Anthem's response to the announcement and we're hopeful that they will work through it with us,” said John Katsianis, the chief financial officer of Augusta Health.

The hospital says roughly 17,000 patients have used Anthem over the last year.

Augusta Health has sent letters to Anthem members who have been seen at Augusta Health in the past year, explaining the situation. A representative of the hospital says if a patient has not received that letter, it should be arriving soon.

A representative with Anthem responded via email saying, "We will continue to work in good faith over the next few months in hopes of coming to an agreement that is in the best interest of our members and customers."

The hospital hopes to have a concrete resolution by mid-November.

Regardless of its contract status, the emergency department at the hospital will remain open for everyone.

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