By Tim Bonfield
The Cincinnati Enquirer

There's no deal yet between Cincinnati's biggest hospital system and one of the nation's biggest Blue Cross & Blue Shield plans.

But representatives of the Health Alliance of Greater Cincinnati and Anthem Inc. say they continue talking.

Neither side will say if they are close to an agreement. Meanwhile, residents, doctors, other hospitals - even local politicians - are sorting out how the impasse will affect their lives and livelihoods.

The contract between the Health Alliance and Anthem expired Dec. 31 - potentially forcing thousands of Tristate residents to seek other hospitals, and in some cases other doctors, for care.

Disagreements are not limited to rates. They include the length of the contract, how the billing system would work, how payments would be adjusted to respond to new technology, and other factors, said Gail Myers, Health Alliance spokeswoman.

The six Health Alliance hospitals include some of the biggest and busiest in town, including the city's only Level I trauma center for adults and the only sources of heart and liver transplants.

Extreme disruptions to care were blunted when the Health Alliance announced that for up to three months it would treat Anthem patients as if they were getting care from an in-network provider. Since Jan. 1, both organizations have received hundreds of phone calls from families asking questions and from employers large and small.

Among those big clients: the City of Cincinnati. Mayor Charlie Luken said he called Health Alliance chief executive Ken Hanover last week to seek information and offer his assistance, if desired.

"They seemed optimistic that things could be worked out," Luken said.

Both sides blame each other for causing the impasse. The Health Alliance says Anthem rejected an offer to work for three months under agreed-upon parts of a partially negotiated contract. Anthem says they were close to a deal before Christmas, until the Health Alliance changed its demands.

Despite a few barbs, Anthem spokesman Joe Bobbey said conference calls, faxes and e-mails have been traded every day this week.

E-mail tbonfield@enquirer.com