HARTFORD, CT — After a seven-week impasse and calls for mediation, Hartford Healthcare and Anthem Blue Cross and Blue Shield reached a three-year deal early Saturday morning.
The inability of the two sides to agree on how much the hospital company would be reimbursed for medical care had left tens of thousands of patients in limbo, forcing them to find a new provider or pay out-of-network costs.
State Comptroller Kevin Lembo called the agreement “bittersweet” today, saying that although it finally delivers relief, it’s “far too late for hundreds of thousands who unacceptably faced disrupted health care. As administrator of the state’s largest employer health plan, I’m grateful to see a resolution, but we must now focus on preventing future disruptions to health care. This case of contract gridlock demands legislative action to protect patients and require mandatory arbitration when large corporations fail to responsibly reach timely agreements.”
The new agreement is retroactive to Oct. 1, which means that any Anthem members who received covered services at Hartford Healthcare facilities will receive coverage for those services at the in-network level.
“Anthem recognizes the disruption caused by the negotiations and the significant impact it had on HHC patients and Anthem members,” Jill R. Hummel, president of Anthem Blue Cross and Blue Shield, said. “Our members remained our number one priority as we worked hard and in good faith to find common ground and reach agreement.”
In a separate statement, Hartford Healthcare apologized for the inconvenience.
“We deeply understand and regret the inconvenience and disruption that being out of network has caused our patients and communities,” Jeffrey Flaks, Hartford HealthCare’s president and Chief Operating Officer, said. “Everything we do is aimed at creating more access to exceptional services. I speak for all my colleagues at Hartford HealthCare in thanking our patients for their understanding during this difficult time.”
Insurance Commissioner Katharine Wade said “I am very glad that both sides focused on consumers and reached agreement.”
Typically, these contract negotiations don’t break down to the extent that they did this time.
The impasse between the two organizations had state officials writing letters trying to encourage negotiators to reach a deal.
Rep. Sean Scanlon, co-chair of the legislature’s Insurance and Real Estate Committee, said he’s glad the two sides reached an agreement, “but it doesn’t change the negative impact this had on Connecticut families for the last seven weeks or the need to us to get answers on behalf of our constituents like why this went on for so long and how we can avoid future interruptions on this scale going forward.”
The committee has scheduled a hearing on the issue Nov. 28.
Lembo, who manages the state employee health insurance contract, had called the stalemate an “outrageous failure.”
He later joined West Hartford officials and the chairmen of Connecticut’s two federally recognized tribes in a letter to the CEOs of Hartford Healthcare and Anthem, calling their inability to reach a deal “unnecessary and unacceptable.”
Daniel Livingston, an attorney, for the State Employees Bargaining Agent Coalition, sided with Anthem in the dispute.
“Hartford Healthcare’s use of ever increasing amounts of healthcare dollars” appears to be driven more by an “attempt to gain market share and power than to improve medical services for patients and communities,” Livingston wrote earlier this month. “These are the kinds of issues that make healthcare less and less affordable and available for working families and the communities in which they live.”
Frances Padilla, president of the Universal Health Care Foundation, said Thursday that the acquisition of multiple providers and health care systems leaves consumers with nowhere to go in these disputes.
“The struggle between these big hospital systems and Anthem is like two sumo wrestlers suffocating the consumer between them,” Padilla said.
She said the legislature needs to step in and protect the consumers from these disputes, which are likely to increase in frequency.
Senate President Martin Looney, D-New Haven, has promised to reintroduce legislation that seeks to create a mediation process for similar contract disputes.
Anthem’s contract with Yale-New Haven Hospital expires next year and many worry that another impasse is bound to happen again.