13-02-2025
Mercy Health could soon be out of network for Cigna
(WKBN) — Mercy Health could soon be out-of-network for Ohioans insured by Cigna commercial insurance.
After months-long negotiations, if an agreement between Mercy Health and Cigna is not reached before April 1, Mercy Health will be considered an out-of-network provider.
According to a release from Mercy Health, they have sought to secure 'appropriate reimbursements' from Cigna. Mercy Health says the current payment agreements 'no longer reflect today's healthcare environment.'
However, Cigna claims the increase requested by Mercy Health is significant and exceeds that of other providers.
'It is disappointing that Bon Secours Mercy Health is choosing to leave our network on April 1,' said a Cigna spokesperson. 'Bon Secours Mercy Health notified us of their intention to leave unless we agree to their significant rate increases across multiple markets. Unfortunately, these increases would make healthcare unaffordable for our customers and their families. We hope that Bon Secours Mercy Health will do what is right for the people we both serve in this community and continue working with us to reach an affordable agreement.'
Cigna reports that Mercy Health 'is demanding' at least a 35% increase over the next 4 years. The company says this increase would then raise costs for those covered by their insurance.
Local impacted hospitals include:
Mercy Health – St. Elizabeth Boardman Hospital
Mercy Health – St. Elizabeth Youngstown Hospital
Mercy Health – St. Joseph Warren Hospital
In its most recent Cost for Caring report, the American Hospital Association reported that hospital prices rose just 2.6% year over year. In contrast, health insurance premiums have risen more than 7%, and Cigna Group, which operates Cigna Healthcare, reported a profit of more than $247 billion in 2024 – an increase of more than 27%.
'Unfortunately, what Cigna pays our doctors, nurses and caregivers is not adequate to account for the cost of providing safe, quality care. We need all of our payer partners to do their part,' Mercy Health stated on its website.
'We have had a positive relationship with Bon Secours Mercy Health, and we want them to stay in our network but only at fair, affordable rates,' Cigna stated. 'We recognize that Bon Secours Mercy Health, like many health care providers across the country, is facing labor shortages and other factors that contribute to cost pressures, but we have a responsibility to keep your health care affordable.'
Mercy Health said patients should receive letters this week alerting patients of negotiations.
More information can be found here.
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