Reid, Anthem reach contract agreement

Reid Health and Anthem insurance have reached an agreement that will allow the healthcare system’s providers to remain in-network for Anthem’s insurance coverage.

Reid announced the agreement March 14 following months of negotiations and concern over whether the two entities would be able to find mutually acceptable terms on a contract that was last negotiated in 1998.

“Through this agreement, we see that Anthem and Reid Health are equally committed to investing in excellent rural healthcare,” said Craig Kinyon, Reid Health president and CEO, in a statement. “Our first priority has always been to ensure our patients have access to the care they need. We appreciate the patience and support of our community and patients as we have worked through this process.”

Patients who were previously using Anthem insurance with Reid providers and services do not need to take any further action and are encouraged to keep scheduled appointments or make new appointments as necessary.

Anyone who submitted a “continuity of care” approval form as a part of the contract uncertainty can see their Reid provider as they have previously.

Those who switched to a new Medicare Advantage plan during the limited election period will remain on that new plan for the remainder of the year.

A letter will go out next week to the same more than 44,000 Reid patients who received the initial notification letter earlier this year, with more information.

“We are pleased to announce that we’ve reached a new multi-year agreement that ensures uninterrupted access to care for our customers at all Reid Health facilities and physician offices,” said Beth Keyser, president of Anthem Blue Cross and Blue Shield, in a statement emailed to WWN. “The contract achieves our goal of providing access to quality care without excessive increases in costs for the employers and individuals covered by Anthem Blue Cross and Blue Shield benefit plans. In addition, we appreciate that Reid shares our commitment to a value-based contract, tying reimbursement to achieving quality benchmarks and improving the health outcomes of our members.”

Reid says the negotiations picked up in earnest last week with representatives from both organizations joining multiple phone calls every day to try to reach an agreement. Acceptable terms were found on Wednesday, March 13, and now the paperwork of the updated contract is being finalized.

“I know this was a stressful experience for our patients, the community and the Reid team, and we’re glad to have it resolved,” said Jason Troutwine, a vice president at Reid. “It may have looked ugly out in the community, but we’ve been in conversation with the Anthem team, working hard and making progress, and behind closed doors that process has gone fairly well.”

There are no expected impacts on patient costs for services related to the new agreement.

Troutwine commended the way the Reid Health team stepped up to take care of patients during the time of uncertainty. He said they conducted daily internal information sharing sessions by phone where directors, leaders, supervisors and providers could join to ask questions about how best to help Reid patients during the negotiations.

Thursday’s call at 8:15 a.m. had 133 people on it, even before the news of the agreement was shared.

The new contract is a three-year agreement that goes through Dec. 31, 2026. It governs how increases for medical care insurance coverage and reimbursement will be handled during that time. As 2027 approaches, Reid and Anthem will again negotiate for updated terms.

A similar negotiating process is beginning to play out with United Healthcare insurance; Reid notified the company in January that new terms would need to be reached in order to continue in-network coverage for Reid patients using UHC products.

“We hope to come to an agreement with them and we’re working hard on it,” Troutwine said.

Reid says it will continue updating the ReidHealthAccess.org information website with details about its relationships with insurers, and will continue staffing the help phone line at 765-965-4250 for patients who have questions.

As for the challenge of preventing these kinds of uncertainties and contract disagreements in the future, Troutwine said that it’s a larger issue that goes well beyond Reid and Anthem.

“The way the system is set up, families are struggling, and rural hospitals are struggling. A lot of parties will have to come to the table on a national scale to figure out how to ensure affordable access to healthcare,” Troutwine said. “I don’t know that anyone has a solution immediately in front of us, and it’s frustrating for everyone.”

Updated March 14 at 11:50 a.m. to include a statement from Anthem.