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Northern Light, Anthem trade jabs over contract negotiations

orange tinted aerial of building facade and flag FILE PHOTO / COURTESY NORTHERN LIGHT HEALTH If the organizations are unable to agree to terms, Northern Light will be out of network with Anthem for physicians and ancillary services effective Oct. 1 and for hospital services effective Dec. 31.
By Laurie Schreiber

The mediation process between Northern Light Health and Anthem Blue Cross Blue Shield broke down last week, with the organizations issuing separate accusatory statements.

Contract negotiations ended mid-August, and the organizations agreed two weeks later to sit down with a third-party mediator to resolve their differences.

Anthem

But on Sept. 24, Anthem accused Northern Light of “abandoning the mediation process we both agreed to” due to issues related to proposed reimbursements and contract changes.

“We are disappointed but remain open to further discussions and compromise,” Anthem said. 

Northern Light

Northern Light responded later that day.

“Northern Light Health is disappointed to hear that Anthem publicly disseminated egregious misrepresentations of our mediation discussions,” said Suzanne Spruce, Northern Light’s senior vice president and chief marketing and communications officer.

"We have made no indication that we are walking away from negotiations and their statements are not constructive to the mediation process," she added. 

On Sept. 26, the organization publicized a letter sent by Tim Dentry, Northern Light’s president and CEO, to Denise McDonough, Anthem’s president.

“At no point have we indicated that we are walking away from the mediation,” Dentry wrote. “In fact, we remain fully engaged, committed and ready to continue working toward a resolution.”

He said Anthem’s recent release of public comments violated mediation principles to which both parties agreed.

He continued, “Our goal throughout this process has not just been about reimbursement. These negotiations are about how we work together to deliver high-quality care. They include operational issues that directly impact how our systems interface, how care is coordinated and how administrative burdens are managed so physicians can focus on what matters: their patients.”

Among the issues, Dentry said, are “shifting requirements” that have “forced” Northern Light “to dedicate an entire administrative team just to manage the complexity of your system.”

Anthem said it is “continuing to help our members navigate care options.”

Looking ahead 

If the two organizations are unable to agree on terms, Northern Light will be out of network with Anthem for physicians and ancillary services effective Oct. 1.  And as of Dec. 31, the health care system will be out of network with Anthem hospital-based services.

Dentry noted that Northern Light has reached new agreements with Community Health Options and Harvard Pilgrim.

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