Courtesy / Northern Light
James Rohrbaugh, Northern Light
8 hours ago
Northern Light Health says contract talks with Anthem have stalled
Negotiations between Northern Light Health and Anthem insurance over reimbursement levels are at a standstill.
Unless contact terms are settled by Sept. 30, Northern Light will no longer be in-network with the insurer, and patients with Anthem coverage will not be reimbursed for treatment at one of Maine’s largest health care providers.
“For years, Anthem has cited rising costs of care to justify increasing the premiums paid by their customers, while our reimbursements from Anthem have seen an average annual increase of less than 1.5%,” James Rohrbaugh, executive vice president and chief financial officer at Northern Light, said in a statement.
“The annual inflation rate for health services has averaged more than 7.5%. Anthem’s unwillingness to keep pace with the costs of providing care directly contributes to the risks facing rural healthcare.”
Reimbursement rates have been cited as a one factor in recent hospital closings in Maine.
Northern Light asserts that payment denials for provided care have measurably increased, while Anthem’s profit margin in Maine climbed by nearly 10% in 2024.
Anthem is the largest commercial insurer in the state, and Northern Light said the insurer has been paying its hospitals and clinics 15% less for outpatient care and 24% less for inpatient care than other Maine healthcare providers.
Northern Light said in statement that it will focus on assisting patients and group policy holders to understand their options should the contract expire, and its website has detailed information.
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