After fallout with Anthem, Northern Light updates Community Health Options agreement

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FILE PHOTO / COURTESY NORTHERN LIGHT HEALTH Northern Light Health’s updated agreement with Community Health Options includes improved rates and less need for prior approval for in-patient treatment.

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By Laurie Schreiber

Less than a week after Northern Light Health ended contract talks with health insurance provider Anthem Blue Cross Blue Shield, Maine’s second-largest health system updated its agreement with Community Health Options, a nonprofit health insurer and plan administrator.

The agreement is aimed at lowering costs and improving access to health care for Community Health Options members who use Northern Light Health's hospitals and facilities, especially those living in northern and rural Maine, the companies said Tuesday in a joint news release.

The agreement includes improved rates and less need for prior approval for in-patient treatment.

Depending on the plan, there are certain “preferred provider copays and coinsurance” and savings on certain services for individuals, families and small businesses in Penobscot, Piscataquis, Somerset, Hancock, Aroostook and Washington counties.

The agreement creates “a more efficient and cost-effective way” to receive and deliver care, James Rohrbaugh, Northern Light Health’s executive vice president and CFO.

In part, lower costs are expected to be generated by a more efficient payment mode that, along with streamlined statements, is expected to result in less paperwork at Northern Light, according to the release.

The agreement eliminates the “prior approval” process for patients who have been admitted to a hospital; and reduces the amount of itemized billing and administrative costs for both companies.

The payment arrangement agreement is effective immediately. Specific plan changes are effective for individual and small group plans beginning Jan. 1, 2026, pending state and federal regulatory approval.

“This new agreement will help us do even more to improve access to high-quality care at a lower total cost, ultimately improving the health and well-being of our members,” said Joanne Lauterbach, CFO of Community Health Options.

Northern Light Health has 1,000 providers working at nine hospitals and more than 127 locations across Maine.