One month after fallout, MU Health Care and Anthem Blue Cross Blue Shield remain split

By Ellie Compton, KOMU 8 Reporter

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    COLUMBIA, Mo. (KOMU) — Anthem Blue Cross Blue Shield and MU Health Care currently have no formal negotiations taking place according to MU, one month after the two failed to reach an agreement to renew their commercial contracts. Anthem became out of network at MU Health Care, leaving over 90,000 MU Health Care patients in the gray.

“We’re not bargaining chips. We’re real people with real health problems,” said Stephanie Timmerman, an Anthem customer. Timmerman is mom to 9-year-old Colton, who has special needs said.

“In rural America, there are not a lot of options of places to go,” Timmerman said.

Colton has apraxia of speech, phonological speech disorder, language disorder, sensory processing disorder, auditory processing disorder, hypothyroidism and mild cerebral palsy.

His disabilities require him to see 6 different pediatric specialists — all of whom are through MU Health Care.

Timmerman first spoke to KOMU 8 a month ago, when negotiations fell through, causing Colton’s specialists to be out of network.

“I didn’t think it was going to get this far.” Timmerman said. “I thought, it’s Anthem, Anthem is accepted everywhere.”

One month later, her son’s health care is on hold.

“We were in March determining if he needed a second ear surgery,” Timmerman said “We got pushed off to mid-May.”

Most Anthem members receiving intensive care could still be able to visit MU Health Care professionals for in-network rates through the continuity of care plan, which had a deadline of at least 90 days.

“It took them 24 days to approve his continuity of care,” Timmerman said. “At no point in those 24 days did they tell me he was going to be approved, it was a done deal.”

Timmerman said during those 24 days, she didn’t advocate to reschedule his appointments because she believed his care plan did not have an extension, after calling Anthem three times and not hearing an answer.

Once she found out his plan had been extended, Anthem informed her those 24 days she was unaware of the extension would be included in 90-day extension deadline.

“I’m thankful they did approve them, however, I feel it a little unfair to take 24 days and then take that away from our time of care,” Timmerman said. “I mean, I called three times, and not one time did anyone ever say it’s going to be a done deal.”

Even with the extension, Timmerman is still hoping for the two to come to an agreement.

“From what I’ve read, they’ve not raised their offer one time,” Timmerman said. “MU has come down, they’ve not gone up. It doesn’t seem like much of a negotiation, so please, negotiate. We need this desperately, for our children, our future.”

New Statements from MU Health & Anthem Blue Cross Blue Shield MU Health Care initially asked Anthem for a rate increase of 39% over the next 3 years.

On April 10, KOMU 8 learned MU Health Care had come down from its initial ask of 39%, however MUHC spokespersons did not clarify by how much.

None of the statements that Anthem has sent to KOMU 8 detail any change on its offer.

Thursday, an MU Health Care spokesperson sent KOMU 8 a statement:

“We remain open to meaningful discussions with Anthem, but there are no formal negotiations scheduled at this time.

Unfortunately, Anthem has only proposed an increase of 1-2% annually, which doesn’t even cover the general cost of living increases. Over the past three years, we’ve experienced an average increase of 7.3% per year for labor, supply and drug costs, while the average reimbursement rate only increased 3.1%. Anthem pays below average compared to other health insurance companies, and it’s simply not sustainable.

Four hospitals in our service area closed in the last 6 years, and 47% of rural hospitals in Missouri are at risk of closing, with reimbursement rates playing a major factor. We’re not willing to put mid-Missouri care at risk.”

An Anthem Blue Cross Blue Shield spokesperson also sent KOMU 8 a statement on Thursday:

“Anthem’s priority remains keeping healthcare accessible and affordable because if it’s not affordable it’s not accessible. The rate increases proposed by MU Health Care, across every offer they’ve made, are not affordable. No one is getting increases over the next three years at the pace MU Health Care is demanding —particularly for the more than 80% of our clients who are self-funded and pay these costs directly. Public-sector employers, Taft-Hartley funds, local businesses and individuals bear the full weight of those increases.

We’ve put forward an offer that exceeds the Consumer Price Index (CPI) annually. Our proposal also includes quality-based incentives that would allow MU Health Care to earn even more by meeting standards consistent across our network. MU Health Care has rejected this offer and, to date, has never met the benchmarks required to earn those quality incentives.

Our goal has always been, and remains, to have MU Health Care as part of the Anthem network — just not at any cost.”

In the meantime, Colton’s mom said she’s waiting for the two to come to an agreement, as the nearest in network hospital is three hours away from her home in Cairo.

“I mean the fuel adds up eventually, but at least it’s 45 minutes, versus three hours one way, that’s a different ball game,” Timmerman said.

She said finding new specialists and being put on waiting lists would be even more stressful than waiting to be an in-network patient again at MUHC.

“The number of times we would have to travel out of town, the cost of fuel, I have an older vehicle…Time off work, wear and tear on a vehicle,” Timmerman said. said these are just some of the reasons she wouldn’t want to drive three hours there and back to get in network care. “I’m trying to hang on with Colton as long as possible at MU in hopes that something gets signed,” Timmerman said.

But for now, she feels the community’s support. “There’s hundreds and thousands of stories out there like my family’s, and we all need to speak up so that MU and anthem can hear us say that we need this contract, and it’s important,” Timmerman said.

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Jacob Richey
jrichey@missouri.edu
5738846397