By Rosana Garcia
Like watching reruns of old sitcoms on television, here we are again, with a major insurer and health provider arguing over their contract. Unlike a well-loved sitcom, though, this is no laughing matter.
Anthem will no longer cover health services provided by Yale Medicine as of October 7, unless the two can resolve a contract dispute.
This is a rerun, with slightly different actors, of other public contract disputes between insurance carriers and providers.
- In April 2015, UnitedHealthcare and two Hartford Healthcare hospitals went down to the wire in their contract negotiations.
- In October 2014, Hartford HealthCare and Anthem made up quickly, though Hartford HealthCare was briefly out of Anthem’s network.
- And in June 2012, CT’s Children’s Medical Center was out of Anthem’s network for two months before resolving their contract..
These disputes often get resolved, but not without alarming consumers and sending those in treatment scrambling for a Plan B. Patients could end up paying higher out-of-network charges for staying with their providers.
In fact, Senate President Martin Looney blasted Anthem and Yale Medicine for putting patients in a bind. Senator Looney’s press release likens patients to “pawns in [Anthem & Yale Medicine’s] battle to increase profits.”
In the end, whether the contract is resolved or not, it is always people who get the short end of the stick. It’s people who get the stress, have to find new providers if the dispute isn’t resolved, and have to navigate an ever-more-complex system that is supposed to care for them.