Deadline looms for Mercy Health, Cigna to agree on insurance coverage
As a Tuesday deadline approaches, ongoing contract negotiations between Mercy Health and Cigna remain unresolved.
If a contract is not reached by April 1, Cigna customers will be considered out of network at Mercy Health facilities.
Patients with chronic or complex illnesses may be eligible for continuity of care, allowing them to continue seeing their current providers at in-network rates. Patients can request continuity of care provision from Cigna, which will decide whether to approve or deny the request.
In a press release issued last week, Mercy Health stated it is working individually with patients to reschedule April appointments and procedures to avoid disruptions in care.
Mercy Health contends that Cigna's reimbursement rates have not kept pace with rising healthcare costs. "Cigna's reimbursements—already substantially less than those of other payers—have not increased in key markets since 2019 and are overwhelmingly inadequate to account for the rising cost of providing health care to the communities served by Mercy Health," the statement said.
The health system cited data from the American Hospital Association and Kaufman Hall, which reported significant industry-wide cost increases, including a 15.2% rise in prescription medication costs, a more than 13% increase in supply costs, and a more than 5% increase in labor costs.
"While costs continued to rise, hospital prices increased by only 2.6%, yet health insurance premiums rose by 6.7%, according to the AHA. Denials and delays from insurance providers like Cigna are increasingly prevalent, leading to significant administrative burdens for health care providers and significant delays in patient care," Mercy Health said.
Cigna, in a statement on its website, acknowledged the cost increases but emphasized its commitment to affordability for its customers. The insurer stated that the increases requested by Mercy Health would significantly raise healthcare costs for its members.
"We recognize that Bon Secours Mercy Health, like many health care providers across the country, is facing labor shortages and other factors that contribute to cost pressures, but we have a responsibility to keep your health care affordable," Cigna said.
Cigna stated it wishes to maintain its relationship with Mercy Health, but the two sides have not yet reached an agreement.
