A third Maine health care provider is dropping Anthem insurance
Coastal Women’s Healthcare, one of the largest obstetrics and gynecology medical practices in Maine, has told its 22,000 patients it plans to stop accepting insurance coverage from Anthem Inc. (NYSE: ANTM), saying its reimbursement rates are too low.
The pull-out by the Scarborough practice follows similar decisions by Maine Medical Center in Portland and Fore River Urology in South Portland.
Coastal sent a letter to patients saying it would not accept any new Anthem patients after Aug. 23. The change does not affect patients who have insurance through their employment at MaineHealth and the practice will continue to see pregnant patients in the middle of an active care plan, regardless of their due date.
“Our current rates of reimbursement for services we provide to Anthem's members are much too low to allow us to continue to provide the level of quality care that our patients have come to expect from us,” Coastal said in its letter.
“We have proposed rates to Anthem that are sustainable for our practice but would still position us as an affordable alternative to other practices in the area. Despite our attempts to create a better partnership between Anthem and Coastal Women’s Healthcare for the benefit of our patients, they have not provided a serious response to our proposals to do so."
Anthem said it believes Coastal is an important part of its network and it urged the practice to re-engage in contract negotiations.
“We have offered them generous increases over the next several years, which they rejected. We’ve also offered a one-year extension with a substantial increase in rates to provide time to finalize a longer-term deal, which they also turned down. Instead, Coastal Women’s is insisting on a 70 percent increase in reimbursement rates, which we cannot agree to because it will greatly impact affordability for our members,” said Stephanie DuBois, spokesperson for Anthem Blue Cross and Blue Shield in Maine.
“It’s extremely disappointing they have chosen to walk away from negotiations by announcing an intention to leave our network, understandably causing concern among consumers."
Fore River Urology also notified patients it would no longer accept Anthem commercial plans as of Aug. 1 and no longer accept Anthem Medicare Advantage plans as of Sept. 1.
MaineHealth last month said its flagship hospital, Maine Medical Center, will stop accepting Anthem in 2023, claiming Anthem owed the health care system more than $70 million for services dating back over three years. MaineHealth also said Anthem had been reducing negotiated payments to Maine Medical Center.
MaineHealth’s seven other hospitals in Maine and one in New Hampshire will continue to be part of the Anthem network.
Indianapolis-based Anthem is one of the nation’s largest health insurance companies. A member of the Blue Cross Blue Shield Association, it provides coverage to people in Maine and 13 other states.
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