Scarborough-based Coastal Women's Healthcare announced Wednesday it's terminating its contract with Anthem. It's the third health care provider in Maine to announce it's leaving the Anthem network over payment or reimbursement issues.
The OB/GYN practice sent letters to eight-thousand patients announcing their decision, which will take effect August 23. The president of Coastal Women's Healthcare, Dr. Barbara Slager says the practice has been trying to negotiate fair reimbursement rates with Anthem after the insurance company reduced them three years ago.
"Three years ago, we were forced to take that because we couldn't contemplate half of our practice potentially leaving if Anthem became out of network," Slager says. "And we've basically been struggling under that contract for three years."
A spokesperson for Anthem, Stephanie DuBois, says Coastal Women's is asking for a 70% increase in rates, which the insurance company cannot agree to in order to keep patient costs affordable. But Dr. Slager says Coastal Women's is asking to be paid the same that Anthem pays other local practices.
"So it sounds like a large increase, but that's only to bring us to parity," she says.
On the website comparemaine.org, which shows the cost of healthcare services at different practices, the average Anthem price for office visits at another independent OB/GYN provider in Portland are more than double the average Anthem price at Coastal Women's Healthcare.
Both Anthem and Coastal Women's Healthcare say they hope they can re-engage in negotiations. If that proves unsuccessful, current pregnant patients covered by Anthem will maintain coverage through postpartum services under a state law that requires continuity of care.
This spring, two other health providers decided to sever ties with Anthem. Fore River Urology in South Portland announced earlier this month it plans to terminate its contract with Anthem in August due to low reimbursement rates. That followed an announcement by Maine Medical Center in April that it would drop out of Anthem's network next year due to payment disputes.
