Augusta Health gathers community support in contract dispute with Anthem

Frustrated by a contract stalemate with Anthem Blue Cross Blue Shileld, Augusta Health in Virginia is gathering signatures for an online petition to persuade the insurer to pay higher rates that are in-line with that of other hospitals in the area.

The petition, online since Friday, has just under 4,000 signatures, according to Augusta Health spokeswoman Lisa Schwenk, director of Communications and Public Relations.

[Also: Anthem, Hartford Healthcare, reach contract agreement]

"The petition came out because we had many people in the community saying we want to support, we want to help," she said. 

Anthem has not responded to the petition, she said. 

Anthem said by statement that is committed to limiting any disruptions that may be caused by the current situation with Augusta Health.

"As we have done for the past several months, we will continue an open dialog with the goal of reaching an agreement that is fair for all parties and will bring Augusta Health back into our network," Anthem said. "We have dedicated customer service teams standing by ready to support consumers who need help finding one of the many other high-quality healthcare providers in the area. Importantly, we want to remind our consumers that doctors within Augusta Medical Group remain in our network through January 31, and it is our hope to have a new contract in place by then; and emergency care is always a covered benefit -- anyone with a medical emergency should always call 911 or go to the nearest emergency department."

[Also: Anthem stops covering non-emergency medical conditions treated in the ER in three states]

As of January 1, Augusta Health is out of network with Anthem. Augusta Medical Group physicians remain in-network until February 1.

Augusta Health has been in negotiations with Anthem since April, Schwenk said. The provider and payer remain in negotiations, but Augusta Health let the public know in October that the two were at an impasse over rates.

"Because the terms were not good, we let (the contract) expire end of December," Schwenk said. "The other hospitals in the region are reimbursed at rates significantly higher than ours."

Anthem has admitted to paying Augusta Health lower rates than other hospitals in the area, she said. There are two hospitals located about 30 miles from the Fishersville, Virginia-based Augusta Health. 

Anthem gave no reason for the lower rates, she said.

"It's significantly less," Schwenk said, though said she could not divulge specific numbers due to ongoing negotiations. "The truth of the matter is, it's a hard stance to take. As that divide begins to grow, we can't afford to exist."

Anthem is among Augusta Health's largest commercial insurers, if not number one, she said. Medicare insures about a third of the health system's population, representing the highest number of patients, at a rate of about 90 cents on the dollar.

The contract dispute has hurt both provider and patients, she said.

Augusta Health is giving patients with Anthem coverage a 30 percent "prompt pay" discount from the balance after the claim has been filed and the patient receives the EOB.

"At some point," Schwenk said of the impasse, "it significantly impacts the care you can deliver. We are working our best to bring this to a fair conclusion."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com