7 recent payer contract disputes, resolutions

Here are seven updates on payer contract negotiations and resolutions:

1. UnitedHealthcare and Greenville, S.C.-based Prisma Health successfully reached an in-network agreement Nov. 11 after a disjointed negotiation process. The announcement rolls out a multiyear agreement that avoided a potential Jan. 1, 2022, deadline. 

2. BlueCross BlueShield of Tennessee announced Nov. 8 that The University of Tennessee Medical Center and University Physicians' Association will support Blue Network L as it expands to Knoxville next year. The network is the lowest-cost BlueCross network to date and will be offered in three regions in the state. 

3. Anthem is negotiating to continue its in-network agreement with Atlanta-based Northside Hospital System. The parties have until Dec. 30 to decide whether to continue their 30-year relationship, which affects about 400,000 patients.

4. Blue Cross and Blue Shield of Texas received a formal contract termination notice from Houston-based Memorial Hermann Health System, the provider told Becker's on Nov. 9. The move is considered "routine" and kicks off a negotiation process that holds about 100,000 patients in limbo. 

5. WellCare reached an agreement with Prospect Medical that brings its San Antonio facilities into its network. The move is retroactively effective Aug. 1. 

6. UnitedHealthcare struck an agreement with Atlanta-based Piedmont Health, bringing its 16 hospitals and 800 facilities in network starting Jan. 1, 2022. 

7. WellCare penned agreements with Iora Health Primary Care practices in three markets, including Houston, Charlotte, N.C., and seven Georgia cities.

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