Anthem & Health Alliance reach deal on insurance

By Kimberly Holmes – bio | email

CINCINNATI, OH (FOX19)  - Welcome news for hundreds of thousands of insured people in the Tri-State. Anthem Blue Cross Blue Shield and Health Alliance hospitals reached an agreement late Wednesday night.

Anthem spokesperson Kim Ashley said a contract was signed shortly before 10 p.m. on Wednesday. Ashley said that means no changes for subscribers. The agreement includes all Anthem products in which the Health Alliance currently participates.

"Anthem and the Health Alliance are working together to provide access to affordable, quality health care, which benefits everyone in the Greater Cincinnati community," said Terry Frech, Regional Vice President, Anthem Blue Cross and Blue Shield in Ohio. "We thank our many employer customers and members for their patience and understanding during this process."

The Health Alliance currently includes University Hospital, University Pointe Surgical Hospital, West Chester Medical Center, The Drake Center, and Fort Hamilton Hughes Hospital, as well as approximately 135 primary care physicians with Alliance Primary Care.

"We are pleased to continue our relationship with Anthem and very happy that our patients will see no change to their care or physicians," said Diana Maria Lara, spokesperson for the Health Alliance.

The contract between Health Alliance hospitals and Anthem Blue Cross Blue Shield was set to expire at midnight on April 1, 2010. That would have meant hundreds of thousands of insured locals would have needed to find new doctors or pay higher rates to keep their old ones. It's reportedly the third contract battle between Anthem and the Health Alliance in the last six years. The last few months have been an emotional ride for many patients, insurers and hospital personnel.

"We are having to move their surgeries because we can't guarantee that it'll be covered at this hospital," said Patty Hoerlein who schedules surgeries at University Hospital.

Hoerlein said this week she's fielded dozens of calls from patients and called dozens of others to reschedule surgeries.

"It's a lot of work," Hoerlein said. "It's a lot of work to put a surgery on anyway, but when you've put everything on and you've done everything and now you have to move everything at the last minute, it's hard for the patient. It's hard for us"

And hard for subscribers.  Many Anthem customers first read the news last month in a letter that warned contract negotiations with Anthem weren't going well. The companies said it all comes down to rates Anthem pays when its clients use Health Alliance facilities and personnel.

If a deal wasn't inked by midnight, subscribers would have needed to either foot more of the bill, paying out of network rates for their old doctors, or find new ones.

Ashley said last year 100,000 members saw a doctor who worked within the Health Alliance network. That's about one in five members in the Greater Cincinnati area. Ashley said in all, there are about 500,000 Anthem members within the region.

Members are urged to call the Member Service phone number on their Anthem ID cards if they have questions about their benefits.

Anthem provides insurance for FOX 19 employees.

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