Mount Carmel Health and Aetna have reached a multi-year agreement. The deal was made just hours before their existing contract was set to expire. The new agreement means that patients with Aetna insurance plans can still get care at Mount Carmel hospitals and from their healthcare providers at in-network costs.
Without the new deal, patients could have faced disruptions in their coverage. Mount Carmel said on its website that it is happy with the outcome. It stressed how important it is for patients to have easy access to care.
This news comes after another big agreement in central Ohio. The Ohio State University Wexner Medical Center made a deal with Anthem Blue Cross and Blue Shield earlier this week. This will keep its medical facilities within the covered network.
Both agreements show ongoing efforts in the region to make sure patients can still get important healthcare services without any breaks in coverage. Excellus BlueCross BlueShield and St. Joseph’s Health have reached a multi-year contract agreement.
It started on Wednesday, January 1, 2025. This will keep St. Joseph’s Health in the Excellus BCBS provider network.
A spokesperson for St. Joseph’s Health confirmed the agreement late Tuesday night. They released a statement saying:
“St.
Joseph’s Health and Excellus BCBS are glad to reach an agreement that allows St. Joseph’s Health to remain in the Excellus BCBS network while preserving patients’ access to high-quality care that’s as affordable as possible. Excellus BCBS members can continue to seek care from St.
Joseph’s Health as they always have without disruption.”
The media has been focusing on this multi-billion dollar dispute between Trinity Health and Excellus. Patients have been caught in the middle. Starting in September, patients with St.
Mount Carmel and Aetna reach deal
Joseph’s Health began getting letters. The letters said there was a high risk that coverage under Excellus may be gone in 2025.
St. Joseph’s Health President and CEO Steven Hanks told patients in that letter that Excellus is often denying patient claims and has delayed payments. He called on Excellus to “pay us fairly for the care we provide.”
At that time, it seemed like the two sides might not reach a new agreement.
Some patients decided to change insurance providers during the open-enrollment period at the end of 2024. In recent weeks, agreements seemed to be moving in the right direction. The two companies agreed to an extension through the end of February.
Aetna, a CVS Health company, and Trinity Health of New England have reached an agreement. It will allow patients and members to keep in-network access to Trinity Health care and facilities. The deal was finalized just days before the current agreement was set to expire.
There were worries that many patients insured by Aetna would lose their in-network status with the health system’s hospitals and doctors. In a New Year’s Eve statement, CVS Health said, “We are pleased to share that Aetna and Trinity Health of New England have reached a multi-year agreement that will allow our valued patients and members to maintain in-network access to the Trinity Health hospitals, facilities, and health care providers they trust. We are thankful for everyone’s patience and support as we worked together to reach a fair agreement.”
Trinity Health of New England confirmed that the new agreement would keep the health system’s hospitals, facilities, and providers in the Aetna network.
The health system stated on its website, “Patients should continue to schedule an appointment for care without experiencing disruption.” The agreement ensures that patients can keep visiting their Trinity Health facilities and doctors for care as usual. The negotiations between Trinity Health and Hartford-based Aetna focused on reimbursement rates for services. Trinity Health said that the previous reimbursements did not adequately cover the “true cost of care we provide.” Despite this, Aetna had been increasing premiums and out-of-pocket costs for its members.
Reports say Aetna’s profits topped $5.6 billion in 2023. The contract negotiations covered Aetna’s commercial coverage, including employer-sponsored plans, and Medicare Advantage plans, which offer Medicare coverage plus additional benefits. Aetna had acknowledged the approaching December 31 deadline.
It expressed hope for an agreement that would keep Trinity Health in its networks while keeping healthcare services affordable. Trinity Health, a not-for-profit organization, cited rising supply and labor costs as challenges to maintaining high-quality care. It emphasized the need for fair payment to provide essential services to patients.
Trinity Health of New England includes several facilities: Saint Francis Hospital in Hartford, Mount Sinai Rehabilitation Hospital in Hartford, Saint Mary’s Hospital in Waterbury, Johnson Memorial Hospital in Stafford Springs, and Mercy Medical Center in Springfield. This agreement marks a significant resolution for many Connecticut residents who rely on these services as they head into the New Year.