Missourians Left Behind in MU–Anthem Dispute

A breakdown in talks between Anthem and MU could lead to disastrous consequences for many Missouri families.

Continued negotiations between MU Health Care and Anthem Blue Cross Blue Shield have failed to produce a new agreement, leaving approximately 90,000 Missourians without commercial coverage more than four months after the original contract expired.

On Monday, representatives from both organizations appeared before the Missouri Senate Insurance and Banking Committee at the Capitol. The hearing, led by Chair Sen. Sandy Crawford, gave lawmakers an opportunity to question both parties and hear directly from affected families.

Patient Stories Highlight the Impact

During the hearing, Crawford read aloud personal stories submitted by residents. One account came from a family whose daughter underwent open-heart surgery at MU Health Care as a newborn and again at age two.

Now four years old, the child may require future surgeries. But with the family’s Anthem coverage no longer accepted at MU Health, they’ve been forced to seek care elsewhere.

“The burden this places on families like mine cannot be overstated,” Crawford read. “We’re not just talking about switching doctors. We’re talking about losing the very people that kept our daughter alive.”

MU Health Cites Rising Costs

MU Health Care CEO Ric Ransom told the committee that the health system is facing a 7% year-over-year increase in operating costs. He emphasized that the requested reimbursement increases from Anthem would help sustain clinical operations, urgent care facilities, pharmacies, and expand patient services.

“What we have said to Anthem is that we need fair market rates to be able to provide the same services,” Ransom said.

Ransom added that MU Health is seeking reimbursement comparable to peer institutions, including the University of Kentucky, which operates a similarly sized academic health system.

He also stated that MU Health has repeatedly attempted to negotiate with Anthem over the past year, but that Anthem “hasn’t meaningfully engaged” since prior to the contract’s expiration.

Anthem Responds with Accusations

Anthem offered a different account. Rich Novack, president of commercial markets at Elevance Health (Anthem’s parent company), told the committee that MU Health Care turned down continuity-of-care proposals twice and accused the hospital system of “patient abandonment.”

“This is a technical and legal term where a benefit exists, but the physician or other provider refuses to see a patient that they used to see simply because of a change in coverage,” Novack said.

Novack also referenced MU Health’s current two-star rating (out of five) from the Centers for Medicare & Medicaid Services. While he noted that the rating was not the reason for Anthem’s lower reimbursement offer, he said the insurer expects improvements in quality of care.

Continuity of Care in Limited Situations

After the April 1 contract termination, some Anthem members have still been able to receive in-network care through a continuity-of-care agreement. This applies to patients receiving care for pregnancy, cancer treatment, transplants, and recent surgeries.

Outside of those specific cases, most Anthem members lost in-network access to MU Health facilities and providers. That loss has especially impacted patients in rural areas, where MU Health is often the only nearby provider.

Stalemate Continues

Despite the ongoing efforts, Ransom made it clear during the hearing that no agreement is in sight.

“The reality today is, we are not close,” Ransom said. “And we have never been close.”

The hearing did not produce any clear resolution, and both sides appear firm in their positions. In the meantime, thousands of Missourians remain caught in the middle, with their care plans, finances, and health outcomes hanging in the balance.

While on the surface the talks may not have looked to be productive, it is possible yesterday’s hearing was a necessary first step towards a longterm solution.