Lebanon, OH – March 26, 2025
As of April 1, 2025, patients with Cigna commercial insurance plans may find that Mercy Health is considered out-of-network. This situation has arisen due to ongoing negotiations between Mercy Health and Cigna regarding a new contract that would provide fair reimbursement for the high-quality care Mercy Health provides.
Cigna’s current reimbursement rates are already lower than those of other payers. Furthermore, these rates have not increased in key markets since 2019, and are now considered inadequate to meet the escalating costs of delivering healthcare within the communities Mercy Health serves. The health system, like other providers across the United States, is facing significant challenges related to rising inflation, labor expenses, and supply costs.
The American Hospital Association (AHA) and Kaufman Hall have reported industry-wide cost increases over recent years. This includes notable increases in prescription medication costs (15.2%), supply costs (over 13%), and labor costs (more than 5%). While healthcare costs have substantially increased, hospital prices have only risen by 2.6%. Data from the AHA indicates that health insurance premiums have simultaneously increased by 6.7%.
Healthcare providers are also dealing with an increase in denials and delays from insurance providers such as Cigna. This trend leads to greater administrative burdens for providers and can cause significant delays in patient care. Despite Cigna’s 2024 revenue exceeding $247 billion, which is a 27% increase, the company has declined to offer Mercy Health fair reimbursement rates. This situation forces patients to make difficult choices between finding new medical providers or paying out-of-network rates.
“As providers of high-quality, compassionate care, we are committed to serving every patient who comes through our doors, and Cigna’s refusal to help ensure in-network access for our patients is incredibly disappointing,” stated Leonardo Lozada, MD, Chief Clinical Officer from Cincinnati. “Our patients deserve access to care when needed, and reimbursement to cover growing costs to provide care is part of the equation. We implore Cigna to reimburse our providers fairly for the care they provide every day. We urge patients to call Cigna on the number on the back of their insurance card and let them know how important it is to keep Mercy Health in their network.”
To minimize disruptions, Mercy Health is proactively assisting patients in rescheduling April appointments and procedures as allowed by scheduling parameters. Patients managing chronic or complex illnesses may be eligible for Continuity of Care, which would allow them to continue seeing their usual care team at in-network rates, even if Mercy Health exits the Cigna network. Patients can work with their providers to submit a Continuity of Care request to Cigna, although the final decision on approval resides with Cigna. For more information, visit www.mercy.com/cigna-updates.
