Cigna members could lose coverage at Chesapeake Regional if contract isn’t worked out

Cigna Healthcare members could lose coverage for services at Chesapeake Regional Healthcare as soon as June 1 if a contract between the national insurance company and the local health system is not worked out.

Chesapeake Regional has had a “positive relationship” with Cigna for almost 20 years, according to an advertisement in The Virginian-Pilot. However, in the most recent reimbursement contract talks, Chesapeake Regional has said Cigna is pushing for lower reimbursements while the health system is seeing inflated costs like other health providers.

“We have been more than accommodating by responding to Cigna’s desires for new contractual terms and are extremely perplexed that Cigna would mislead its members with an assertion that Chesapeake Regional is requiring higher-than-average rates. This is simply untrue,” said Reese Jackson, president and CEO of Chesapeake Regional in a news release. “Chesapeake Regional represents high value services at a fair and appropriate price and is more than willing to reach an accord.

A statement from Cigna put the blame for the impasse on Chesapeake Regional.

“We want to keep health care affordable, especially as our clients and customers are managing rising prices due to inflation,” a statement from the insurance provider said. “Unfortunately, the majority of services that our customers access at Chesapeake (Regional) are more expensive than other local hospitals, and each year their rate increases have outpaced other area hospitals.”

Cigna says if a deal is not reached, it will help customers find new providers that are in network.

Chesapeake Regional, like all hospitals, will still see any patient in an emergency. Chesapeake Regional also pointed to Cigna’s size and No. 12 ranking on the Fortune 500 list.

Both parties did not provide a number of how many people could be affected by the lapse of the contract and provide any specifics about the contract under negotiation.

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Earlier this year, a similar contract negotiation impasse threatened Optima members’ ability to get care from Bon Secours.

Also, like Chesapeake Regional and Cigna, the two parties declined to provide information about the specific aspects of the impasse. However, Sentara Healthcare, which operates Optima, said that about 54,000 people would have been affected if Bon Secours and Optima not reached a deal, which they ultimately did about a week before the expiration date of March 1.

Optima echoed Cigna’s concerns — rising costs from the provider and the burden that would have on plan members, while Bon Secours health system made similar points to what Chesapeake Regional is saying in their impasse with Cigna.

“Like many health systems across the country, Bon Secours’ Hampton Roads and Richmond markets have realized that years of increased costs require significant increases in health plan rates in order to continue to provide medically necessary covered services to contracted health plan beneficiaries,” a February statement from Bon Secours said about their negotiations with Optima. “Bon Secours takes pride in our ability to efficiently provide quality care to patients; however, we cannot continue absorbing the cost of inflation while delivering high-quality care, without payers, like Optima, keeping pace with the cost of care.”

Last year, the number of Americans who reported putting off care because of cost reached a 20-year high as almost 4 in 10 Americans told Gallup pollsters they delayed care because of the costs.

Experts argue different factors are pushing health costs up, from the shortage of medical providers and the costs of drugs, to the scale of insurance companies and local and regional monopolies of health systems.

Ian Munro, 757-447-4097, ian.munro@virginiamedia.com