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Christ Hospital, Anthem negotiate agreement ensuring access to care

The Christ Hospital
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CINCINNATI — Anthem Blue Cross Blue Shield and The Christ Hospital Health Network have reached an agreement to ensure continued access to care.

The announcement comes after various negotiations, and a Christ Hospital spokesperson previously said Anthem was hard to negotiate with.

"Anthem is committed to providing access to high-quality, outcomes driven health care," said Jane Peterson, president of Anthem. "We're pleased to have worked in good faith with The Christ Hospital Health Network to ensure our members can continue to access the care they need."

According to the announcement, the new agreement will build on Anthem and Christ's long partnership to "deliver care that will improve the health of those we collectively serve."

If an agreement between the two was not reached prior to April 1, patients could have been paying out of pocket.

"It's unacceptable," patient Paola Holbrook previously said. "It's shameful that we're in this position."

Many like Holbrook said they are anxious they could lose their coverage. Because Holbrook has a strong family history of breast cancer, she decided to do genetic testing.

"In October of last year, I did test positive for the BRCA1 gene mutation," Holbrook said.

Holbrook said she wanted to be proactive and take control of her health. She scheduled a double mastectomy surgery for April 20. Now, due to something out of her control, Holbrook could have lost her insurance coverage for the procedure.

"The decision to go through with the surgery is a very emotional one. And this is a curveball that has been thrown that no one should have to really deal with," she said. "You want to have peace of mind knowing that, through the surgery and beyond you're going to be covered."

Anthem previously provided WCPO with the following statement:

“The Christ Hospital Health Network has informed us of their intent to leave Anthem’s care provider network unless we agree to allow them to drastically increase prices for the people and businesses we serve. Cost increases of this magnitude — more than double the current inflation rate for hospital services — are unacceptable, especially when Greater Cincinnati families and businesses are already struggling with a difficult economy. To be clear, these increases would directly impact consumers through dramatically higher out of pocket costs and indirectly through higher insurance premiums. In response, Anthem has offered Christ Hospital responsible increases that are in line with those recently accepted by other area health systems and include opportunities for millions in additional value-based payments for meeting industry standard measures for quality care. We will continue to work in good faith to reach an agreement that maintains our members’ access to quality, affordable care at Christ Hospital and their employed physicians.”

Those with the Christ Hospital previously said higher costs for customers is not their intention, but rather a fair market rate of reimbursements.

"It's not clear to me that us getting fair and equitable reimbursement would have any further impact on patient premiums," said Dr. Burns Blaxall, head of Precision Medicine with The Christ Hospital.

Both Anthem andThe Christ Hospital have websites with more information for patients who are directly impacted.

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