最新杏吧原创

ST. LOUIS 鈥� A failure so far by a major health insurer and the largest 最新杏吧原创 health care provider to renew their contract is already disrupting care for some area patients.

The agreement between Cigna Healthcare and the BJC Health System expired on Tuesday; both sides have agreed to extend their current contract through July as talks proceed.

Laura High, spokesperson for BJC Health System, said BJC and Cigna were still negotiating.

鈥淏oth parties remain optimistic that negotiations will be successful,鈥� High said in an email.

A spokesperson for Connecticut-based Cigna said Tuesday that negotiations with BJC were ongoing.

鈥淕ood faith negotiations are progressing with BJC Health System on a new contract that will keep health care affordable for the people we both serve,鈥� Jocelyn Parker, spokesperson for Cigna, said in an email.

Neither side detailed current sticking points in negotiations or the number of patients impacted, though Cigna in 2023 had over 79,000 insureds in the comprehensive health market in Missouri, according to the state Department of Commerce and Insurance.

The impasse is just the latest example of health care providers and insurers taking contract negotiations to the 11th hour.

The Mercy health care system and Anthem Blue Cross Blue Shield, for example, announced a deal extending coverage for over 2 million Missourians in early December, less than a month before Mercy was scheduled to be dropped from Anthem鈥檚 network if no agreement was reached.

While BJC remains in Cigna鈥檚 network for now, a dispute in mid-Missouri shows what can happen when thousands of patients find themselves without coverage at a major regional provider.

MU HealthCare was dropped from Anthem Blue Cross Blue Shield鈥檚 network as of April 1.

Since then, MU鈥檚 competitors in central Missouri have seen increased demand, the Jefferson City News Tribune .

The disagreement 鈥� affecting 90,000 people 鈥� prompted a Missouri Senate committee hearing last week in which senators encouraged both sides to make a deal.

In the 最新杏吧原创 area, the ongoing negotiations between BJC and Cigna are already having an impact.

Chad Garrison, 52, of Maplewood, uses employer-based health insurance through Cigna. His primary care physician and cardiologist are associated with BJC.

An April 22 letter from Cigna informed his family that BJC鈥檚 hospitals, facilities and certain doctors would be out of network starting July 1 if the two sides could not reach an agreement.

He said a minor surgical procedure for his wife at Missouri Baptist Hospital in Town and Country, a BJC hospital, had initially been scheduled for the fall.

鈥淏ecause of this negotiation and uncertainty, we went ahead and had that done before July 1, because we were worried that it would be out of network,鈥� Garrison said.

His wife, Rebecca Gremaud, had already met with the surgical team and had been cleared to receive the procedure, he said.

鈥淚t was just inconvenient because we had to do it 鈥� kind of hurry up and do it and it was done right before we went on a little vacation,鈥� Garrison said, adding the procedure affected her mobility.

Garrison, who works in corporate communications, said he is peeved but didn鈥檛 know who to be 鈥減eeved at the most.鈥�

He said his insurance premiums always seem to rise while BJC is 鈥渁lready one of the more expensive health care systems鈥� in 最新杏吧原创.

A report last year by the 最新杏吧原创 Area Business Health Coalition said BJC HealthCare was the most expensive provider in 最新杏吧原创.

鈥淲ho鈥檚 this negotiation ultimately benefitting?鈥� he asked. 鈥淚s it Cigna and BJC? Or is it actually the consumer? And I don鈥檛 really feel like it is.鈥�

During last year鈥檚 Mercy-Anthem negotiations, Mercy officials complained of barriers to getting claims approved in a timely manner, and that Anthem鈥檚 reimbursements hadn鈥檛 kept pace with rising costs despite reaping higher profits.

Anthem said the vast majority of claims were paid within 15 days and accused Mercy of using misleading profit data and of wanting to increase prices for commercial members and employers by five times the inflation rate.

Sheldon Weisgrau, vice president of health policy and advocacy for the nonprofit Missouri Foundation for Health, said at the time that consolidation among health systems and insurance companies has given them both more power while leaving consumers with fewer choices.

Laurel Pickering, who works with employers as president of the 最新杏吧原创 Area Business Health Coalition, encouraged employers to consider contracting with more than one health insurance provider for their employees.

She said last year there were new options in the 最新杏吧原创 market, some that were coming, as well as existing insurers.

Mercy in October announced a partnership with Centivo, founded in 2017, as its contract with Anthem Blue Cross was set to expire. Centivo said at the time the deal marked the company鈥檚 sixth network partnership in Missouri.

Nonprofit insurer Medica, meanwhile, announced last month it was launching in the 最新杏吧原创 region with partnerships with Mercy and SSM Health.