WINCHESTER — The expiration date of Valley Health’s current contract with Anthem Blue Cross Blue Shield has been pushed back to March 31 as negotiations for a contract renewal continue between the Winchester-based health system and the insurance provider, according to Valley Health President and CEO Mark Nantz.
In response to questions about the negotiations, Nantz said he remains optimistic about renewing a contract with Anthem.
The current contract was previously set to expire on Dec. 31, but because negotiations are active, the agreement has automatically been extended three months, Nantz stated via an email from Valley Health Senior Marketing and Communications Director Carrie Brooks Manuel..
Failure to renew the contract would mean that 55,000 Anthem patients who seek care annually at Valley Health facilities would be out-of-network with the regional health care provider in April.
“Both parties continue to negotiate in good faith. As a result of being in active negotiations, our contract has been automatically extended through March 2024,” Nantz said.
Asked about the focus of the negotiations, Nantz said payor contracts are complex and include high-level payment and pricing agreements as well as hundreds of pages of contract language and payment terms.
“We are reviewing every aspect of the contract including reimbursement rates, provider network participation, rate schedules and much more, all of which has an impact on the negotiations and final contract benefits,” Nantz said.
He said Valley Health’s goal is to have a final decision on the matter by Dec. 31 of this year.
Valley Health, which serves a population of about 500,000 people in the region, is parent company of Winchester Medical Center and five other hospitals in the region, in addition to more than 60 medical practices and Urgent Care centers, as well as other health care facilities. Operational statistics for the 2022 calendar year include 29,000 hospital admissions, 140,000 emergency department visits and 17,000 surgical cases.
Valley Health sued Anthem in October of 2022 to recoup $11.4 million in past due payments. Though initially filed in Winchester Circuit Court, the suit advanced to federal court and increased to $15 million. In April, the two parties reached a settlement.
At a Valley Health System Corporation meeting in May, Nantz updated stakeholders on the recently resolved lawsuit and said he was “very optimistic” about 2024 contract negotiations.
This marked a major improvement from January, when Nantz announced that the two parties remained in a “severe disagreement” over the claims dispute.
Numerous people who live in the Winchester area have reached out to The Star in recent weeks seeking an update on the negotiations. Some have indicated that they face health insurance enrollment deadlines.
“We understand how difficult this negotiation process has been for our patients and we recognize that it can be stressful to be uncertain about access to the physicians and hospitals you trust,” Nantz said. “I want to extend my personal thanks to the members of our community for their patience as we work to secure a contract with Anthem.”