Negotiations continue between Covenant Health, Anthem Maine before July expiration

Published: May. 17, 2023 at 4:48 PM EDT
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BANGOR, Maine (WABI) - Covenant Health Maine and Anthem Blue Cross/Blue Shield are negotiating and trying to come to an agreement before their current ones expire in July.

This could impact patients at Saint Joseph and Saint Mary’s hospitals.

The companies have been working together for several months on these negotiations.

The insurance company says the main issue comes from Covenant Health’s pricing.

Covenant Health claims they want their prices to provide fair reimbursement for providers and hospitals, while keeping it affordable for patients.

Anthem claims Covenant Health proposed prices are three times the rate of inflation.

Both sides will continue to negotiate in good faith, as both sides think they share the goal of providing quality, affordable healthcare to Mainers.

If the two companies don’t come to an agreement, all patients who go through St Joseph’s and St Mary’s will have to find another provider.

Covenant Health’s statement:

“For many months, Covenant Health has been working in good faith to come to a contract agreement with Anthem Maine that protects our patients’ access to Covenant Health hospitals, outpatient facilities and physicians at St. Joseph Healthcare in Bangor and St. Mary’s Health System in Lewiston, Maine. It is our goal to reach a new agreement with Anthem before our current agreements expire on July 1, 2023, and we have every reason to believe that Anthem shares this goal.

Payer contract negotiation is an increasingly complex process. Every negotiation is different, and our team has spent months assessing how best to move forward with Anthem to ensure we are able to provide our patients with the high-quality health care they need and deserve. One of the most important issues in our negotiations with Anthem is to protect our patients’ relationships with their physicians. Throughout the negotiations, we have also been clear that we want to structure an agreement that provides fair reimbursement for our providers and hospitals and continues to offer our patients access to the medical services they need at an affordable rate.”

Anthem Blue Cross and Blue Shield’s statement:

“Anthem Blue Cross and Blue Shield is dedicated to providing access to quality, outcomes-driven healthcare, and we believe Covenant Health shares this goal. Our work also centers on affordability and that is where we currently differ from Covenant Health. We have offered reasonable and competitive increases over the next several years that are in line with other health systems. However, Covenant Health is demanding double-digit rate increases that are more than three times the rate of inflation – increases Maine consumers and businesses cannot afford. We will continue to negotiate in good faith over the next month and a half in an effort to reach a new agreement. However, we are now preparing to direct Anthem members to other high-quality providers in the area that offer a wide range of healthcare services – and often at lower costs – should we be unable reach a consumer-friendly agreement. We have a responsibility to those we serve to keep care affordable, and we will continue to fulfill that responsibility through our discussions with Covenant Health.”

One important note – our contract with Covenant Health runs through July 4, 2023, which is the last day their facilities and professionals will be in network unless we can come to an agreement before then. The July 1 date is incorrect.

Also, we have a public website with more information about our negotiations that members can access at