Why We Are Negotiating

Mercy is dedicated to providing high-quality, accessible health care to the people of Missouri, and we’ve worked hard over the past year to reach an agreement with Anthem that allows us to continue doing so. Unfortunately, despite months of negotiations, Anthem has consistently presented terms that undermine our ability to deliver the care our patients need.

Contrary to what Anthem suggests, this is about more than financial terms — it’s about ensuring our patients have uninterrupted access to comprehensive, compassionate care in a timely manner without the red tape and barriers put into place by Anthem. Though Mercy’s costs, like those of every health care provider, have risen due to factors outside of our control, such as inflation and labor shortages, we are simply asking for a contract that reflects the realities of today’s health care landscape.

Addressing Misinformation

Mercy is not demanding drastic rate hikes, as Anthem’s statements have claimed. We are seeking fair reimbursement that enables us to continue providing high-quality care without placing undue financial pressure on our system, the employers who rely on us and patients and families in Southeast Missouri who choose us for their health care. Anthem’s characterization of our proposals does not align with the facts. In the St. Louis region, according to payer transparency files, Mercy is currently 22% less expensive on average than other providers. Having Mercy in your network helps keep costs down, without us, costs will go up.

It’s also important to address the claim that we are jeopardizing access for Medicaid and Medicare Advantage members. Mercy has been a steadfast provider of care to vulnerable populations for decades, and this commitment will not change. We remain focused on serving all members of our community, regardless of their insurance status or financial circumstances. Each year, Mercy provides about a half billion dollars of care and support to those unable to pay.

Putting Patients and Co-Workers' Care First

The heart of this matter is simple: Mercy is here to care for communities in Southeast Missouri and across the state, and that means advocating for agreements that reflect our mission. Anthem has had the opportunity to step up and work with us to build a contract that supports patients and caregivers alike. Yet, their approach has focused more on protecting shareholder profits than on ensuring frictionless or timely access to essential services for patients.

We are advocating for a deal that addresses systemic issues with Anthem’s practices. Among our patients and co-workers, we have seen the detrimental effects of Anthem’s complex processes, denied claims and delayed approvals. We have heard from a number of our patients who have voiced concerns on how tests and procedures ordered by their health care provider are repeatedly denied; even instances when a covered claim was paid and then retracted, leaving the patient on the hook. For health care co-workers, Anthem is creating barriers to care by placing unnecessary administrative burdens on them, which leads to increased costs for patients, delays in receiving necessary care and a negative impact on patient wellbeing.

At Mercy, we’re looking toward the future — investing in virtual care, expanding primary care access and providing solutions to keep patients healthy, not just treat people when they’re sick. This isn’t about individual price points; it’s about creating a system that works for everyone — patients, employers and health care providers alike.

What Happens Next

Mercy will remain in Anthem’s network through the end of 2024, and we will continue to provide our patients with the care they need during this time. If a new agreement is not reached, we will do everything possible to ensure smooth transitions for all our patients.

We hope that Anthem will continue to be at the table with us, prepared to negotiate in a way that reflects our shared responsibility to our community. In the end, we believe that putting patients first should guide these discussions, and we remain committed to making that happen for Stoddard County and Southeast Missouri.

For more information, please visit mercy.net/anthem.