Obamacare Patients Caught in Insurer-Hospital Crossfire

Thousands in Atlanta may be without coverage thanks to an inability to reach a contract.

Breaking up is hard to do for thousands of patients and beneficiaries associated with WellStar and Anthem in Atlanta. WellStar is a major provider, owning or contracting with hospitals, urgent care centers and physicians. It and Anthem cannot come to a contract agreement for Anthem’s ACA plan, which means WellStar’s providers will not be part of the insurer’s network.

“Health care providers are consolidating to negotiate tougher deals with health insurance companies, who in turn are both pulling back from the places they’ll cover and taking a tough line on what they’ll pay,” reports the Atlanta Journal-Constitution

Neither WellStar nor Anthem will say how many patients will lose coverage on February 4, when the current contract between the two companies expires.

And, of course, they only have nice things to say about each other.

Kidding.

Actually Anthem and WellStar each blamed the other for the contract impasse.

WellStar’s statement: “Unfortunately, although WellStar has repeatedly requested a proposal from Anthem Blue Cross Blue Shield to participate in their Pathways health exchange products, we have not been offered a contract to participate.” WellStar added that it was “surprised and disappointed.”

Anthem’s statement: “Unfortunately, we could not come to an agreement on affordability with WellStar, which chose not to continue to participate in (Anthem’s Pathway product, the policy for individuals and some groups) as other providers have.”