Anthem BlueCross BlueShield and CommonSpirit Health Contract Dispute: What Patients Need to Know

Anthem BlueCross BlueShield of Colorado and CommonSpirit Health Fail to Reach Agreement, Patients Face Uncertainty

In a concerning turn of events, a major Colorado insurer and a large hospital system have failed to reach an agreement by their Tuesday deadline. Anthem BlueCross BlueShield of Colorado and CommonSpirit Health, which owns 11 hospitals in the state, including St. Anthony Hospital in Lakewood, couldn’t come to terms on how much the insurer should pay for procedures.

As of Wednesday, CommonSpirit is no longer in Anthem’s network, leaving Anthem-insured patients who visit any of the health care system’s hospitals potentially facing higher costs. The difference between what Anthem pays and what CommonSpirit charges could amount to thousands of dollars, as federal and state laws only protect against surprise bills for emergency care.

CommonSpirit, which owns the Catholic hospitals from the former Centura Health partnership, released a statement requesting a temporary contract extension while negotiations continued. Anthem, on the other hand, accused CommonSpirit of disrupting patient care as a bargaining tactic and emphasized its commitment to reaching a collaborative, multi-year agreement.

Patients who are pregnant or undergoing treatment for complex conditions like cancer may still receive care from CommonSpirit providers through July. However, the ongoing dispute has raised concerns about the impact on patients and the accessibility of affordable healthcare.

Colorado Insurance Commissioner Michael Conway urged both parties to continue negotiating, emphasizing the importance of considering the well-being of consumers. If a deal cannot be reached, the Division of Insurance suggested that individuals in areas without alternative hospitals could reach out to Anthem for exemptions, especially in cases where weather conditions impede travel.

The uncertainty surrounding the situation highlights the challenges faced by patients when healthcare providers and insurers cannot come to an agreement. As negotiations remain behind closed doors, patients are left in the dark about the specifics of the dispute and the potential consequences for their care and finances. Stay tuned for further updates on this developing story.