Northern Light Health announced Tuesday that their leadership is now open to engaging in mediation with Anthem Blue Cross Blue Shield as a “last-ditch effort” to come to an agreement before their current contracts expire.
Just over a week earlier, Northern Light announced that it would be ending talks with Anthem after months of stalled negotiations.
Unless an agreement can be reached, all physicians and some ancillary services will become out-of-network with Anthem on October 1, followed by all hospital-based services on December 31.
The entire Northern Light Health system would become out-of-network with all Anthem Medicare Advantage Plans as of January 1, 2026.
“We cannot predict whether mediation will be successful should Anthem agree to this process, but it is the right thing to do as we continue to prioritize the best possible outcome for our patients,” James Rohrbaugh, CPA, Northern Light Health’s executive vice president and chief financial officer, said in a statement Tuesday. “We hope that Anthem will agree to mediation.”
Click Here to Read Northern Light Health’s Full Statement
Anthem spokesperson Jim Turner told the Bangor Daily News that the insurer had reached out to Northern Light Health late last week to open a conversation about bringing in a mediator to help successfully negotiate a new contract.
“We are pleased that Northern Light is in agreement with Anthem about taking this next step in our negotiations,” Turner said in a Tuesday email to the Bangor paper.
While Northern Light has accused Anthem of undercutting them financially, the insurance provider intimated that the health care system’s demands would cause millions of dollars in cost increases for other Anthem members over the life of Northern Light’s proposed three-year agreement.
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.
[RELATED: Northern Light to End Talks with Anthem After Months of Tense Negotiations]
Although a similar dispute played out between Anthem and MaineHealth in 2022, the two were able to reach a deal before the contract expired, averting interruptions for patients.
Patients insured by Anthem and receiving care at Northern Light facilities will not necessarily be forced to go elsewhere if their contracts expire, but any services rendered would be treated as out-of-network.
As a result of this, any Anthem-insured patients that choose to continue receiving care at Northern Light facilities would likely face higher out-of-pocket costs.
Medicare Advantage patients would have the ability to choose a new plan or return to original Medicare during the open enrollment period between October 15 and December 7.
Those who have Medicare Supplement Plans — also known as Medigap Plans — through Anthem will not be impacted, as these plans do not have network requirements in Maine.
