Negotiations between Northern Light and Anthem have reportedly stalled as the expiration date of their current contract quickly approaches at the quarter’s end.
The clash between Maine’s largest commercial insurer and one of the state’s primary medical service providers has seemingly left many with a sense of uncertainty and frustration.
While Northern Light is seeking increased reimbursement rates from Anthem citing an average annual inflation rate of 7.5 percent in the health services industry, Anthem has accused Northern Light of wanting to impose a 30 percent price hike that would primarily be borne by Mainers.
Should the current contract expire before the two groups can reach an agreement, all hospitals and service providers will become “out of network” for any Mainers insured through Anthem.
According to Northern Light, Anthem has only increased their reimbursement rates by less than an average of 1.5 percent annually, failing to keep pace with the average 7.5 percent inflation rate in the industry.
Anthem, on the other hand, has argued that Northern Light wants to implement a 30 percent price increase, creating an estimated $218 million in new healthcare costs, most of which they say will fall on the shoulders of patients and employers in the form of co-payments and premiums.
Northern Light has painted Anthem as unwilling to keep up with rising costs, while Anthem has framed Northern Light as wanting to drastically increase costs for patients.
“Anthem’s unwillingness to keep pace with the costs of providing care directly contribute to the risks facing rural healthcare,” James Rohrbaugh, NLH Executive Vice President and Chief Financial Officer, said in a June statement.
“Our negotiations focus on healthcare affordability,” Anthem says on its website. “We negotiate on behalf of our members and Maine employers to secure affordable care at Northern Light Health and all our provider partners.”
According to Anthem, their contract with Northern Light Health is set to expire on September 30, but out-of-pocket costs for patients would not change until January 1.
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