Anthem and Mount Sinai have reached a new multi-year contract agreement, restoring coverage for thousands after the system went out-of-network last month.
Anthem Blue Cross and Blue Shield of New York said in a statement Monday that the three-year deal returns Mount Sinai's hospitals, physicians and other providers to its network. The health plan said that the contract "reflects both organizations’ commitment to delivering quality care while helping control healthcare costs for New York workers, families, employers and taxpayers."
The contract also includes updated reimbursement models that aim to reward quality and outcomes, while continuing to support accurate billing and payment.
The insurer and health system have been engaged in active contract discussions for months, with an initial deadline for a deal set for Dec. 31. When that date passed, a New York state law prevented any changes for patients until March 1, per CBS News.
CBS reports that on that date, about 9,000 doctors employed by Mount Sinai went out-of-network for about 200,000 Anthem enrollees.
“Most importantly, we were able to work with Mount Sinai to protect our members’ access to care while keeping costs as low as possible for the families, employers, and taxpayers who pay for healthcare,” said Victor DeStefano, commercial president of Anthem Blue Cross and Blue Shield in New York, in the announcement. “We appreciate the hard work by both teams that made this agreement possible, and we look forward to serving New Yorkers together for years to come.”
Anthem said that the new contract also includes "reasonable price increases" alongside value-based care models that can help to control unnecessary costs.
On its own site, Mount Sinai says it is "pleased" that the two reached an agreement and noted that the contract does not extend to Anthem's Medicare Advantage or individual marketplace plans. For people enrolled in those plans, the system pointed them to a website for additional details.
"We know this period of uncertainty may have been stressful for you and your family. If your care was disrupted in any way, we understand the worry or inconvenience this may have caused," the health system said. "Throughout this process, our focus has been on protecting your access to the Mount Sinai physicians and services you depend on, ensuring we can continue delivering the high-quality care you deserve."