Mercy, Anthem reach contract agreement, ending dispute before 2025 deadline

Mercy and Anthem Blue Cross and Blue Shield in Missouri, or Anthem, have reached a new multiyear contract agreement providing Anthem health care insurance members with continued access to care at all Mercy hospitals, care centers and physician offices statewide.

In a Wednesday, Dec. 4, news release, the two companies announced that Anthem members covered by employer-based, Medicare Advantage and Affordable Care Act Marketplace health plans in Missouri would have in-network access to Mercy doctor and care sites.

Additionally, Missouri Care Inc., doing business as Healthy Blue, had reached an agreement for Healthy Blue Medicaid plans and would likewise have uninterrupted access to Mercy services.

Company representatives said they did not have any further details to provide at this time.

The Mercy hospital organization had announced Sept. 9 that it would end its contracts with insurance provider Anthem on Wednesday, Jan. 1, 2025, if an agreement had not been reached by then. At the time, they said months of negotiations had proven fruitless.

Mercy had criticized Elevance Health, the corporate name for Anthem, for not reimbursing the hospital organization for the care it provides despite Elevance Health’s year-over-year net income and profit margin each increasing by more than 24%.

Mercy representatives had also said Anthem’s administrative processes, such as its 48-hour required notification system for whenever Anthem members are admitted to emergency care, were a barrier to timely, appropriate treatment.

Anthem, meanwhile, had said Mercy wanted to increase the prices charged to Anthem members and employers by five times the then-current inflation rate and wanted contract language keeping specialty medications more expensive than lower-cost options.