CommonSpirit and Anthem announce 5-year deal to restore in-network coverage
After failed negotiating and a passed deadline left thousands of patients out of network, CommonSpirit Health and Anthem Blue Cross and Blue Shield reached a new deal on Friday.
The health care and insurance providers failed to agree on a new contract two weeks ago, leaving about 7,800 El Paso County patients of CommonSpirit’s hospitals and clinics without Anthem’s in-network coverage and on the hook for higher medical bills.
The new 5-year deal provides retroactive in-network coverage starting from May 1, according to a Monday statement from the Colorado Division of Insurance. That means Anthem-insured patients of CommonSpirit hospitals and clinics across the state will be billed the usual percentage or copay for treatment sought in the past two weeks, rather than an higher out-of-network cost.
“Each day this dispute continued was another day of disruption, worry and work for consumers as they scrambled to find care,” said Colorado insurance commissioner Michael Conway in the statement. “Each side had legitimate concerns, but it was the people of Colorado who were caught in the middle.”
The two left the negotiating table on May 2 despite a request for a week-long extension from CommonSpirit. The dispute between providers was over what each considered reasonable reimbursement rates to the nonprofit CommonSpirit for coverage, though the financial details have not been released.
The insurance impasse directly affected Penrose Hospital and both St. Francis hospitals in Colorado Springs, along with 18 other hospitals, emergency and urgent care centers statewide.
In a statement earlier this month, Anthem accused CommonSpirit of disrupting care to “demand unreasonable price hikes.” The nationwide insurance company also alleged that CommonSpirit, which replaced Centura Health as the hospital system manager a year ago, was asking for reimbursement above twice the rate of inflation.
CommonSpirit chief medical officer Dr. Oswaldo Grenardo told the Gazette earlier this month that his organization was seeking “a fair and reasonable contract.”
Neither side has released details about the new deal, which could ultimately impact insurance premiums as statewide health care costs rise.
“I’m proud that both organizations stayed at the negotiating table, working hard to reach an agreement to provide Coloradans’ access to affordable health care at CommonSpirit,” said Anthem Colorado President Matt Pickett in a statement.
CommonSpirit said in a statement that the agreement would allow patients to continue to receive “compassionate care” from their current medical care professionals.
“Our goal has always been to ensure we can meet the needs of our patients while continuing to provide essential services to our communities today and into the future,” said Andrew Gaasch, executive vice president and chief financial officer of the CommonSpirit Mountain Region, in a statement.
Anthem clients could apply for continuity of care benefits to maintain in-network prices for prescheduled appointments or procedures before the deal went through.
How the deal will affect patients who already sought alternate continuity of care is up to Anthem, said the Division of Insurance. The DOI said people with ongoing major medical concerns like pregnancy, inpatient care, non-elective surgeries or terminal illness should reach out to the insurance provider for questions.






