UW Health providers could be unavailable to some patients insured by Anthem Blue Cross Blue Shield Wisconsin if a new agreement isn’t reached by April 15. The health system and the insurer are currently in negotiations, but disagreements over payment terms are posing a challenge.
UW Health announced that they are trying to renegotiate their current agreement with Anthem, which designates UW Health providers as in-network. The current agreement is set to expire on April 15th. The Madison-based health system has stated that Anthem is proposing payment rates that are lower than what other Wisconsin health systems receive and that don’t keep pace with inflation.
UW Health also claims that Anthem wants the ability to modify payment terms in the future without any further renegotiation. They believe this potential policy, in combination with what they describe as an excessive use of prior authorization requirements, could result in delays or even denials of necessary patient care.
Emily Snooks, who serves as public relations director for Anthem, reported that the insurer is hoping to keep UW Health within its network, and they will continue to negotiate. However, Snooks also stated that the rate increase UW Health is seeking is “excessive.”
“UW Health is requesting a 32 percent price increase over three years for Anthem members,” Snooks said in an email. “This increase is more than four times the current rate of inflation in the first year alone for care at certain UW Health facilities.”
The announcement from UW Health indicated that patients who have Anthem insurance are starting to receive notification regarding the possible termination of the agreement. People with commercial insurance, those with Medicaid, and those with Medicare Advantage plans could be affected by this change.
“While we hope to avoid this outcome, we believe securing fair terms and payment for the care we provide is essential to the long-term well-being of our system and our ability to continue providing remarkable care for our patients,” stated UW Health leaders in an official statement.
