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After public dispute, MaineHealth and Anthem aren't sharing details of their new insurance agreement

George HW Bush Falls
David Sharp
/
AP
This July 16, 2015 photo shows the Maine Medical Center Thursday, in Portland, Maine.

After months of negotiations, MaineHealth and Anthem have successfully negotiated a contract.

The agreement, announced Wednesday night, means that Maine Medical Center will no longer withdraw from Anthem's network next year. While health care advocates are pleased that patients won't see disruptions in care, they are raising some concerns about the deal.

MaineHealth announced in April that it would remove its largest hospital, Maine Medical Center, from Anthem's network in 2023 because the insurance company owed millions in outstanding payments. Anthem, meanwhile, said it was merely holding MaineHealth accountable and had recently found $20 million in overcharges.

If the split had gone through, patients covered by Anthem would have faced higher costs at Maine Medical Center because services would have been billed as out-of-network. It had the potential to be a major disruption to health care access in the state.

So it was welcome news when the two sides announced they had reached an agreement Wednesday night. Gov. Janet Mills praised both parties for resolving their differences.

The executive director of Consumers for Affordable Health Care, Ann Woloson, also said she was pleased — if cautiously so.

"We do have concerns about the lack of transparency that goes into these agreements," says Woloson.

MaineHealth and Anthem are not releasing the details of their agreement. And without more information, such as how rates were decided, Woloson says it makes it hard to know what effect the agreement could have on wider health care costs in the state.

"We're happy that Maine Med has reached an agreement with Anthem. But we do have concerns about what this might mean for overall health care costs in Maine in general," she says.

Woloson hopes that lawmakers will take a closer look at ways to increase transparency in the next legislative session.