OhioHealth in negotiations with Anthem

SCOTT TRUXELL/independent editor

OhioHealth, which operates 16 hospitals in Ohio, including OhioHealth Van Wert Hospital is cautioning patients that an existing contract with Anthem will expired July 31 and if the two sides can’t reach a new agreement, OhioHealth will be designated as an out-of-network provider, effective August 1.

Should that happen, OhioHealth and its physicans would no longer participate in the Anthem network, meaning those with Anthem as an insurance provider would have their coverage impacted.

“If you are an Anthem member, and Anthem is no longer in network with OhioHealth, effective August 1, 2025, your coverage will not include elective health services at OhioHealth,” according to a statement by OhioHealth. “You can still access emergency care at OhioHealth, regardless of health insurance coverage. This is not the outcome we want, but without fair solutions from Anthem, we may have no other option.”

OhioHealth officials said the two sides are actively working toward a renewal and there seems to be optimism that a new agreement will be reached before the deadline.

“We are negotiating to reach a new, long-term agreement to remain in-network with Anthem,” OhioHealth spokesperson Lindsey Gordon said in an emailed statement. “We are continuing to provide care for our patients who are covered by Anthem and are optimistic we will reach a new agreement before the current contract expires.”

OhioHealth’s website has a page that specifically concerns what has been happened as well as the current status.

“At this time, Anthem and OhioHealth are no more than two percentage points away from finalizing our negotiations,” a statement said. “But Anthem is insisting on including language that would make it even more difficult for OhioHealth to be paid for services that it has provided to our patients, and more difficult to obtain prior authorization to provide that care. For OhioHealth, those are key considerations as they are critical to ensure patients have easy and ready access to care, as well as to ensure timely payment to OhioHealth for services rendered.”

OhioHealth also claims that Anthem is in breach of the current contract.

“They are not working with us to resolve over $6 million of claims that are over 60 days old. Anthem continues to deny claims and authorize services that ultimately block care for our patients. These delays can lead to real problems for patients who need timely care and treatment.”

Anthem and Fort Wayne-based Parkview Health were recently engaged in similar contract negotiations. The two sides announced last week that a new multi-year agreement had been reached, preserving the health system’s in-network status.