CommonSpirit and Anthem Come to an Agreement

Denver Post -

One of Colorado’s largest insurers and one of its major hospital systems have reached a deal, ending more than two weeks of uncertainty for patients. CommonSpirit Health went out-of-network with Anthem BlueCross BlueShield of Colorado on May 1, meaning patients could be responsible for paying a larger share of their medical bills if they sought care at one of CommonSpirit’s hospitals or clinics.

In Colorado, CommonSpirit owns 11 hospitals including St. Anthony Hospital in Lakewood, (and St. Elizabeth Hospital in Fort Morgan) as well as eight urgent care centers, two surgery centers, seven home health and hospice providers, 26 radiology centers and five physician groups.

Under the terms of the five-year contract announced late Friday, patients who received care at CommonSpirit facilities during the time they went out-of-network will only have to pay their usual share of costs, whether that’s a percentage of their hospital bill or a flat co-pay for an office visit. The two sides had disagreed on how much Anthem should pay when its customers receive care at CommonSpirit facilities. Neither released any information about the rates they ultimately agreed on. Anthem Colorado President Matt Pickett said that agreeing to a five-year deal would keep costs predictable for customers. Andrew Gaasch, executive vice president and chief financial officer of CommonSpirit’s mountain region, said the contract would allow hospitals to be sustainable.

Rate disputes have become more common as both insurers and hospital chains consolidate and try to use their market share to get the best rates. In 2021, UCHealth went out-of-network in Anthem’s plans sold on the individual marketplace in the Denver area, though the sides reached a deal to bring them back a year later.