Anthem Blue Cross Blue Shield could drop UW Health as in-network provider

Wisconsinites with health insurance from Anthem Blue Cross Blue Shield Wisconsin may soon lose access to providers at UW Health and UnityPoint Health-Meriter.

UW Health said in a statement Friday that efforts to renegotiate its agreement with the insurance company have not been successful. The current agreement that designates UW Health providers as in-network expires April 15.

The Madison-based health system claims Anthem is offering payment rates that are below what the company pays other Wisconsin health systems and that do not keep up with inflation. 

UW Health also said Anthem wants to be able to change payment terms in the future without renegotiation. The health system claims the policy, combined with what they describe as an “overuse of prior authorization requirements,” could lead to delays or even the denial of care for patients.

Emily Snooks, director of public relations for Anthem, said the insurer would like UW Health to remain in its network and will continue to negotiate.

However, Snooks said the rate increase UW Health is seeking is “excessive.”

“UW Health is requesting a 32 percent price increase over three years for Anthem members,” Snooks said in an email. “This increase is more than four times the current rate of inflation in the first year alone for care at certain UW Health facilities.”

The statement from UW Health said patients with Anthem insurance have started to receive notification of a potential termination of the agreement. The change would impact people with commercial insurance and those with Medicaid and Medicare Advantage plans.

“While we hope to avoid this outcome, we believe securing fair terms and payment for the care we provide is essential to the long-term well-being of our system and our ability to continue providing remarkable care for our patients,” said UW Health leaders in the statement.