Confusion, fears of sharply higher medical costs and plans to forego doctor visits to save money were the initial responses Monday from some patients following the collapse of a deal between Hartford HealthCare and Anthem Blue Cross Blue Shield.
Tens of thousands of patients are now classified as out-of-network, forcing higher out-of-pocket costs for health care at hospitals, doctors offices and other medical facilities. Hartford HealthCare and Anthem’s failed to reach agreement by the deadline Saturday.
Ryan Wallace, who works in claims for Travelers in Hartford, said his $30 doctor’s office visit will now cost $100 and he will limit or skip his three-day-a-week visits. He declined to discuss his health condition.
“What was manageable is now impossible,” said Wallace, 23. “I guess I just have to wait it out.”
Affected hospitals include Hartford Hospital, the Hospital of Central Connecticut in New Britain, Midstate Medical Center in Meriden, Backus Hospital in Norwich, Windham Hospital in Willimantic and the Institute of Living, a Hartford-based facility that treats mental illness and other health conditions.
Wallace said the number of hospitals involved in the dispute makes matters worse.
“It’s a huge monopoly now,” he said.
Shawn Mawhiney, spokesman for Hartford HealthCare, said the two sides met Monday and reported no progress. He was not aware of the next meeting.
Mawhiney said at least 550 Hartford HealthCare patients submitted “continuity of care” forms asking Anthem to honor in-network rates.
“Unfortunately, being out of network is causing anxiety, confusion and disruption among our patients _ and we want to do everything we can to mitigate that,” he said.
Hartford HealthCare is fielding questions from patients by phone, social media posts and emails, Mawhiney said.
Anthem said in an emailed statement that it expects to meet again in the “coming days.”
“In August when it became more evident that we might not come to an agreement by Oct. 1, Anthem asked HHC whether it would be willing to extend the agreement to avoid disruption to our members, but HHC refused,” Anthem said. “We renewed that offer today and HHC again rejected Anthem’s request.”
Anthem is doing “everything it can” to ensure that members have the right clinical plans so services in process are not interrupted and care can be moved safely to other providers, it said.
David Whitehead, executive vice president of Hartford HealthCare, placed much of the responsibility for an agreement on the other side.
“It is our hope that Anthem will work in good faith to agree to a new contract,” he said in a statement.
Jim Cardon, physician leader at HartfordHealth Care, said in a video that the health care organization is “about saving lives and making people healthier.”
“From where I stand Anthem is about paying or denying insurance claims. There is a big difference,” he said.
The number of affected patients is not known. Mawhiney said he believes it could be between 40,000 and 60,000. State Comptroller Kevin Lembo’s office, which manages health insurance plans for state employees, said about 50,000 state workers who are insured by Anthem are affiliated with Hartford HealthCare, including hospital, health plans and physician groups.
In the absence of a deal between Hartford HealthCare and Anthem, Lembo said he will direct state employees to seek alternative providers.
In previous contract disputes and lapses, acute care hospitals agreed to work with the state plan to make sure health care access is protected and patients will not be required to pay sharply higher out-of-pocket costs, he said.
This time, however, he said, HHC has told the comptroller’s office that state members “may indeed experience disruption and financial impact” with the expiration of the contract, Lembo said.
Ted Doolittle, Connecticut’s Healthcare Advocate, said there is little the state can do to prod Anthem and Hartford HealthCare to reach agreement.
“There’s not a lot we can do other than jawboning, encouraging them to come to an agreement,” he said. “It is a little bit discouraging.”
