Anthem, Hartford HealthCare reach a deal

Anthem Blue Cross and Blue Shield and the parent company of five Connecticut hospitals announced late Thursday that they had reached an agreement on a new contract, allowing the hospitals to return to the insurer’s network.

Anthem and Hartford HealthCare had been unable to reach a deal before their previous contracts expired Oct. 1, leading the hospitals to exit Anthem’s network.

Hartford HealthCare is the largest hospital chain in the state, the parent company of Hartford, Windham and Backus hospitals, MidState Medical Center and The Hospital of Central Connecticut. Anthem is the state’s largest insurer. Their dispute brought the prospect of disruption to the care of thousands of state residents who could have faced the prospect of choosing between paying higher out-of-network rates or switching medical providers.

The joint statement released by the two companies did not include specific details of the new contract, but said it was a multi-year agreement and that the hospitals’ return to Anthem’s network was effective Oct. 1.

During the negotiations, Anthem indicated that a main sticking point was its effort to tie more of the hospitals’ pay to performance, part of a broader movement in health care to reward providers based on patient outcomes and care quality. The focus on “value-based” payments is an attempt to move past the current payment system, in which most health care providers are paid for each service they perform — something widely viewed as rewarding those who deliver more care and failing to provide incentives to coordinate care or make other efforts to improve quality or contain costs.

Anthem and Hartford HealthCare said the new agreement would broaden an existing program aimed at improving coordination of patients’ care. The two companies also plan to implement a chronic care program for patients with complex conditions and work on ways to integrate behavioral health care into Hartford HealthCare’s primary care settings.

“This collaboration presents an excellent opportunity for Anthem and HHC to work together to improve patient health and outcomes while reducing the costs associated with avoidable admissions and ER visits,” Anthem President Jill R. Hummel said in a statement. “When providers are given the tools and resources they need to focus on prevention, wellness and the coordination of care, and are rewarded when they improve health, it’s a recipe for success.”

Hartford HealthCare President and CEO Elliot Joseph said in a statement that the agreement “allows us to work together to continue improving quality, enhancing access to care and making health care more affordable.”

Anthem’s largest customer is the state, which uses the company to administer its employee and retiree health plan. State Comptroller Kevin Lembo, whose office oversees the plan, said the state and other employers will also work with Hartford HealthCare’s physician group, Integrated Care Partners, on pilot programs to coordinate care for patients with chronic conditions such as diabetes, COPD and heart disease.

Gov. Dannel P. Malloy and Lt. Gov. Nancy Wyman, who issued a statement Wednesday chastising Anthem and Hartford HealthCare for failing to reach a deal, released a statement Thursday night praising the agreement and the pilot programs for patients with chronic conditions.

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