Mercy and Anthem announce pact 

An agreement has been reached between Mercy and Anthem Blue Cross and Blue Shield in Missouri, though terms of the agreement were not disclosed. 

In a joint news release, the entities announced the multiyear agreement this morning, saying it will provide Anthem members with continued access to affordable, high-quality care at all Mercy hospitals, outpatient care centers and physician offices across the state of Missouri. 

“With the new contract, Anthem members covered by Anthem employer-based, Medicare Advantage and Affordable Care Act Marketplace health plans in Missouri will have uninterrupted in-network access to Mercy doctors and care sites,” the announcement said. 

The announcement added that Missouri Care Inc., doing business as Healthy Blue, has also reached an agreement with Healthy Blue Medicaid plans. Healthy Blue members will also have continued uninterrupted in-network access to Mercy doctors and care sites, the announcement stated. 

The three-paragraph news release was thin on particulars, and Springfield Business Journal followed up with both parties, asking questions about the specific details of the newly forged agreement.  

A response came from Emily Snooks, director of public relations for Anthem. 

“The media release is all we will be stating about the negotiation,” she said. 

In September, Mercy announced its intention to end its contract with Anthem as of Jan. 1, 2025. A statement from the hospital system said months of negotiations with Anthem had failed to yield a suitable reimbursement agreement. Officials said the cost of providing care had risen significantly, but Anthem’s reimbursement rate had not kept pace with the rising costs, even though it had raised premium costs for patients and employers. 

In a Sept. 13 article, SBJ interviewed Stephanie Vojicic, president of Anthem Blue Cross and Blue Shield in Missouri, and Steve Mackin, Mercy’s president and CEO, and they described the impasse. 

Mercy cited burdensome red tape that made it difficult for its patients to navigate Anthem’s system and receive medically necessary care.  

An Anthem spokesperson said Mercy wanted to increase the prices they charge Anthem members and employers by five times the current inflation rate while also demanding contract language that would keep specialty medications unnecessarily expensive. 

Mercy officials disputed the claim. 

“We don’t know where their five to six times rate statement is coming from,” said Dave Thompson, Mercy’s senior vice president, population health, and president, contracted revenue, in a September interview. “We can’t validate it at any data point throughout the negotiation.” 

Vojicic told SBJ in the September interview that the insurer had responded to Mercy’s demands by offering something over the consumer price index, though she did not disclose the offer. 

Vojicic said roughly 30,000 Anthem members had accessed a Mercy hospital or outpatient care center in the past 12 months. According to Anthem’s website, the insurer has 2.1 million members in Missouri, with 1,520 associates and 88 years on the local market. 

Last month, both parties reported virtually no movement in negotiations. 

Open enrollment in health insurance plans for 2025 began for many companies in October, according to past reporting, and the Affordable Care Act marketplace open enrollment period began Nov. 1, lending immediacy to negotiations.