MU Health ‘out of network’ for Elevance Health/Anthem patients after insurer fails to reach agreement

Declining health outcomes in rural Missouri are getting worse after Anthem Blue Cross and Blue Shield failed to agree with University of Missouri Health Care on higher reimbursement rates for patient care.

Anthem Inc., now known as Elevance Health, is one of the nation’s largest for-profit health insurers, and its Missouri patients now find themselves out of network for MU Health.

Information obtained by The Lion indicates top executives at the company earn millions of dollars per year in total compensation:

• President and CEO Gail Boudreaux: $20.5 million
• COO Mark Kaye: $6.8 million
• VP Peter Haytaian: $6.3 million
• VP Felicia Norwood: $6.3 million
• VP Morgan Kendrick: $5.8 million

Anthem, in particular, went on a public relations blitz earlier this year to convince patients via op-eds – and state officials, through ominous mass emails – that MU Health is being unreasonable in seeking higher reimbursement rates for care.

But the stakes in this dispute are vastly different for each entity. Without an increase in patient care reimbursement rates from Anthem, either:

• MU Health patients receive less care
• taxpayers will have to pay more
• or Anthem simply makes less profit

For his part, Chief Medical Officer for MU Health Care Dr. Stevan Whitt wrote in an op-ed that Anthem “is unwilling to commit to contractual changes that prioritize patient access, alleviate unnecessary administrative burdens and pay MU Health Care rates that cover the increased costs of providing care due to inflation and other market pressures.”

Whitt warned that, with 10 rural hospitals having already closed since 2012, “Our country’s rural communities are becoming increasingly vulnerable as access to care options dwindle.

“We see it in our patients – more frequent occurrences of serious and chronic conditions, increasingly common struggles with prescription drug coverage, higher instances of mental health challenges and so much more.”

In addition, unreimbursed costs at state-run MU Health could put a squeeze not only on patients but on taxpayers.

Meanwhile, op-eds in several news outlets by Anthem-Missouri President Stephanie Vojicic pointedly blame the health care providers at MU Health.

“Despite claiming to want to ‘put patients first,’” Vojicic writes, “MU Health Care has chosen to initiate the termination of our existing agreement and request a 39% price increase over the next three years for Anthem members across employer-sponsored and individual plans.”

The deadline for the agreement was March 31, meaning Anthem patients have been out of network for MU Health facilities in Columbia and throughout central Missouri for all of April.