Christ Hospital patients nervous about losing coverage amid Anthem negotiations

Credit: Nick Graham

Credit: Nick Graham

CINCINNATI — Christ Hospital patients could soon lose their insurance coverage, as the hospital is still in contract negotiations with Anthem for patient services.

These negotiations directly impact all Christ Hospital patients with Anthem Blue Cross Blue Shield Health Plans. If an agreement is not reached before Saturday, April 1, patients could be paying out of pocket.

“It’s unacceptable,” said patient Paola Holbrook. “It’s shameful that we’re in this position.”

A Christ Hospital spokesperson said they’ve been working hard to negotiate, but they keep getting rejected. Many like Holbrook said they are anxious they could lose their coverage.

Because Holbrook has a strong family history of breast cancer, she decided to do genetic testing.

“In October of last year, I did test positive for the BRCA1 gene mutation,” Holbrook said.

Holbrook said she wanted to be proactive and take control of her health. She scheduled a double mastectomy surgery for April 20. Now, due to something out of her control, Holbrook could lose her insurance coverage for the procedure.

“The decision to go through with the surgery is a very emotional one. And this is a curveball that has been thrown that no one should have to really deal with,” she said. “You want to have peace of mind knowing that, through the surgery and beyond you’re going to be covered.”

Anthem said there is no need to cancel anything done in the near future, as there will be a 90-day grace period if an agreement is not reached. Patients will continue to have access to all hospital services at in-network rates trough June.

Anthem provided WCPO with the following statement:

“The Christ Hospital Health Network has informed us of their intent to leave Anthem’s care provider network unless we agree to allow them to drastically increase prices for the people and businesses we serve. Cost increases of this magnitude — more than double the current inflation rate for hospital services — are unacceptable, especially when Greater Cincinnati families and businesses are already struggling with a difficult economy. To be clear, these increases would directly impact consumers through dramatically higher out of pocket costs and indirectly through higher insurance premiums. In response, Anthem has offered Christ Hospital responsible increases that are in line with those recently accepted by other area health systems and include opportunities for millions in additional value-based payments for meeting industry standard measures for quality care. We will continue to work in good faith to reach an agreement that maintains our members’ access to quality, affordable care at Christ Hospital and their employed physicians.”

Those with the Christ Hospital say higher costs for customers is not their intention, but rather a fair market rate of reimbursements.

“It’s not clear to me that us getting fair and equitable reimbursement would have any further impact on patient premiums,” said Dr. Burns Blaxall, head of Precision Medicine with The Christ Hospital.

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