Thursday, January 1, 2004

Health Alliance, Anthem talks failing

By Matt Leingang
The Cincinnati Enquirer

It appears a contract dispute over reimbursement rates has severed ties between Greater Cincinnati's largest hospital group and the region's biggest health insurer.

The Health Alliance of Greater Cincinnati and Anthem Blue Cross & Blue Shield failed to come to terms on a new contract by a midnight deadline Wednesday.

Starting today, Greater Cincinnati residents covered by Anthem may find themselves unable to access services from Health Alliance hospitals, which include Christ, University, Jewish, St. Luke and Fort Hamilton hospitals.

People covered by Anthem who have doctors with the Alliance Primary Care physician group might have to choose a new doctor.

Anthem provides health insurance to 350,000 people in Greater Cincinnati. It is unclear exactly how many would be affected by a break with the Health Alliance.

There was little movement Wednesday on a new contract over reimbursement rates. The Health Alliance proposed extending the contract term through Dec. 31, 2004, while attempting to resolve outstanding contract issues during the next 90 days. But Anthem rejected the idea, according to the Health Alliance.

Despite the chilly atmosphere that characterized the final days of their relationship, both sides expressed an interest in patching things up quickly in 2004.

"We are going to continue efforts to bring them (the Health Alliance) back into our network," Anthem spokesman Joe Bobbey said.

Added Health Alliance spokeswoman Gail Myers: "We're still trying to reach an agreement."

What does this all mean?

People with Anthem insurance may be able to stay with Health Alliance hospitals and doctors if they have out-of-network benefits, but patients would have higher co-payments and deductibles.

Health Alliance officials say they are working to help patients offset those costs.


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