Mercy warns thousands of patients could lose coverage if agreement with Cigna isn't renewed

Slamming Cigna as bad faith negotiators, Mercy Health warned Ohio patients Friday they could be out of in-network employer sponsored coverage if a deal with the insurance provider isn't reached before Jan. 1.

In a statement, the Cincinnati-based health system said it has attempted for several months to reach an agreement with Cigna of Ohio to renew the expiring contract, which covers employer-sponsored plans at Mercy hospitals and medical groups in the health system's Cincinnati, Lima, Youngstown, and Lorain markets.

But Cigna, Mercy claims, isn't negotiating in good faith toward a contract to "keep this care in network." The current contract expires on Jan. 1, 2023.

"In our opinion, Cigna of Ohio is falling short of its responsibility to our community by attempting to pay hospitals and medical practices less than competitive rates, and expecting patients to shoulder the difference," Mercy wrote.

A contract termination would affect 12,000 patients at Mercy hospitals in Cincinnati, Lima, Youngstown and Lorain and 20,000 more at medical group practices in Ohio, a Mercy spokeswoman told The Enquirer.

Specific to Cincinnati, more than 5,500 people who use Mercy hospitals and 8,100 medical group patients could be affected if an agreement isn't reached. Termination of the contract would mean patients in the affected markets who use Cigna for employer-sponsored insurance would no longer be considered in-network at Mercy hospitals and medical groups.

"Patients with this coverage will continue to have access to all Mercy Health hospitals in cases of emergency treatment, regardless of the network status with Cigna," Mercy added in the lengthy statement.

Cigna said it is ready to work with its customers to find another "conveniently located in-network provider" if an agreement isn't made, citing Mercy's "high rates" as reason for the stalled negotiations.

“We would very much like to keep Mercy Health’s physicians in our commercial network, but not at the excessively high rates they are demanding from our clients and customers," the company said in a statement to The Enquirer, adding that price increases would directly impact local companies, employees and families through "higher out-of-pocket costs and increased payroll deductions."

According to an American Hospital Association report released in September, 2022 labor expenses for hospitals is projected to have increased by nearly $135 billion from 2021, while insurance companies report record profits. Last month, Cigna announced a 70% increase in third quarter profits year-over-year from its previous third quarter.

This article originally appeared on Cincinnati Enquirer: Mercy warns patients they could lose Cigna coverage