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How a contract spat between Bon Secours and Anthem could cost you more at the doctor

Posted at 5:39 PM, Jul 31, 2023

RICHMOND, Va. -- The Medicare contract between the Bon Secours hospital system and health insurance provider Anthem is scheduled to end in Virginia on Tuesday.

That means Bon Secours services will become an out-of-network cost for nearly 19,000 Medicare recipients in Virginia and 11,000 in the Richmond area.

Starting on August 1, these patients may be required to pay more money out of pocket to continue seeing their doctor, according to a Bon Secours spokesperson.

Patients could also find another doctor who is in their healthcare network.

Why Is This Happening?

In a statement released earlier this month, Bon Secours said the reimbursement rates provided by Anthem were substantially less than their other partners.

The hospital system said Anthem has not kept up with inflation or rising labor costs.

Anthem accused Bon Secours of using the contract negotiation as a bargaining chip to drive costs higher for people covered through their employers.

Anthem also stated that later this fall, Bon Secours is planning to terminate a contract set in place until 2025 for Anthem Medicaid members.

Anthem said it was working with specific Medicare Advantage members who need to stay under Bon Secours providers and also working with other members to transition to another local healthcare system.

Despite the contract coming to an end, Bon Secours said its emergency services will always be available at no higher cost.

Statement from Bon Secours

Despite months of ongoing contract negotiations, Anthem hasn't provided a contract that addresses the financial burden created by recent inflation and supply chain shortages and build a sustainable partnership that will support the quality care we offer our communities for years to come.

As a result, effective August 1 our Bon Secours providers and facilities will be considered out-of-network for patients with Anthem Medicare Advantage plans. 

Please note that all patients will continue to have access to all Bon Secours emergency departments, regardless of the network status with Anthem.  

We want to continue to negotiate to ensure access to care is available when it’s needed. We encourage Anthem to do what is right for its Virginia Medicare Advantage members, today and in the future, to ensure access to care is not compromised. 

We take a holistic approach to payer relationships and are negotiating all our Anthem contracts, including Medicaid, Medicare Advantage, and Commercial, and we’re asking for modest increases on our remaining contracts to align with the increasing cost of care. 

It is important to note that if an agreement is not reached, the Anthem Managed Medicaid agreement with Bon Secours may terminate on October 1, 2023. 

We will continue to allow ample time for fair and balanced negotiations to reach an agreement before those contracts terminate, just as we’ve done with all our contracts.

- Emma Swann Director, Public Relations & Communications

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