St. Francis ‘deeply disappointed’ by Anthem threat to terminate contracts

INDIANAPOLIS – After months of contract negotiations, the Sisters of St. Francis Health Services Inc. (SSFHS) is dismayed by Anthem Blue Cross and Blue Shield in Indiana’s notice that it would terminate contracts with SSFHS as early as May 1.

Anthem announced the termination in a March 3 communication to its insurance brokers and employer groups.

"We are deeply disappointed by Anthem’s action," said Kevin Leahy, SSFHS president and chief executive officer. "While progress throughout our negotiations has been slow and painstaking, there is a clear understanding between Anthem and SSFHS regarding the issues that keep the parties from agreeing to new contracts."

Leahy added, "Our patients remain our primary concern, and we will continue – as we have done throughout all phases of these discussions – to ensure Anthem-insured policyholders receive the level of benefits and quality of care they expect at all of our medical facilities."

Leahy emphasized that specifics of the negotiations fall under a mutually agreed upon confidentiality agreement, which SSFHS has strictly observed.

During negotiations last fall, SSFHS announced that it had rescinded the termination of the SSFHS contracts with Anthem because progress was being made in discussions. This action also guaranteed that Anthem-insured patients would continue to be served at St. Francis medical facilities throughout the state.

SSFHS officials believe Anthem’s termination announcement is a reaction to the hospital system’s filing of a lawsuit last November in Marion County Superior Court. The litigation, in part, pertains to the use of arbitration under current contracts between St. Francis and Anthem.

SSFHS’ other concerns are related to Anthem’s lack of timely claims reimbursement and the denial of claims related to their processing problems, a situation that has persisted since the fourth quarter of 2007.

The Indiana State Medical Association also has investigated similar problems with Anthem on behalf of its membership.

In a January 2009 report to its shareholders and posted on its Web site, Anthem said it generated net income of $2.5 billion in 2008. In 2007, Anthem generated $3.3 billion in net income for its shareholders. Anthem/WellPoint’s CFO predicts that Anthem will "generate significant positive cash flow in 2009" – standing in stark contrast to the struggle for financial survival facing every other Indiana business, working families and mission-driven hospitals like St. Francis.

Any inquiry into the causes of today’s health care crisis must consider the harmful impact of diverting multiple billions of premium dollars away from providing vital health services for working families.

A Feb. 22 Indianapolis Star article details the growth WellPoint/ Anthem has experienced and anticipates for its future. The article states: "WellPoint’s grip on its hometown health insurance market has more than doubled in the past five years, with nearly 70 percent of common policies now issued by the Indianapolis-based insurance giant… The growing market share gives WellPoint increasing clout in negotiating fees paid to doctors and hospitals throughout the region, contributing to a string of public feuds between WellPoint’s Anthem Blue Cross and Blue Shield and local health-care providers…"

Contracts currently cover the following SSFHS medical facilities and physicians:

• St. Francis Hospital & Health Center (Indianapolis)
• St. Francis Hospital & Health Center (Beech Grove)
• St. Francis Hospital & Health Center (Mooresville)
• St. Elizabeth Regional Health (Lafayette)
• Home Hospital (Lafayette)
• St. Anthony Medical Center (Crown Point)
• St. Anthony Memorial Health Center (Michigan City)
• St. Margaret Mercy Healthcare Center (Hammond)
• St. Margaret Mercy Healthcare Center (Dyer)
• St. Clare Medical Center (Crawfordsville)
• Franciscan Physicians Hospital (Munster)
• More than 300 physicians in the different SSFHS service areas

The affected plans are:

• Anthem Blue Access PPO
• Anthem Blue Preferred HMO
• Anthem Traditional
• Anthem Medicare Advantage PPO
• Lumenos
• Anthem Healthy Indiana Plan.

Media Contacts:
Joe Stuteville
Media Relations Manager
317-782-7986
317-946-9930 (cell)
317-909-0079 (pager)
Joe.Stuteville@ssfhs.org

Kelli Searles
Director of Community Relations and Marketing
317-782-7983
317-985-5132 (cell)
317-424-1362 (pager)
Kelli.Searles@ssfhs.org

Anthem contract termination rescinded; patients will continue to receive in-network care

INDIANAPOLIS – The Sisters of St. Francis Health Services Inc. today (Nov. 7) announced it would rescind plans to terminate its contract with Anthem Blue Cross and Blue Shield in Indiana, thereby ensuring patients will continue to receive in-network benefits.

St. Francis and Anthem officials say they have made progress in negotiating a new multi-year contract and will continue their discussions until an agreement is reached.

An agreement would cover the following SSFHS medical facilities and physicians:

• St. Francis Hospital & Health Center (Indianapolis)
• St. Francis Hospital & Health Center (Beech Grove)
• St. Francis Hospital & Health Center (Mooresville)
• St. Elizabeth Regional Health (Lafayette)
• Home Hospital (Lafayette)
• St. Anthony Medical Center (Crown Point)
• St. Anthony Memorial Health Center (Michigan City)
• St. Margaret Mercy Healthcare Center (Hammond)
• St. Margaret Mercy Healthcare Center (Dyer)
• St. Clare Medical Center (Crawfordsville)
• Franciscan Physicians Hospital (Munster)
• More than 300 physicians in the different SSFHS service areas

The affected plans are Anthem Blue Access PPO, Anthem Blue Preferred HMO, Anthem Traditional, Anthem Medicare Advantage PPO, and Anthem Healthy Indiana Plan.

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About Sisters of St. Francis Health Services Inc.
Headquartered in Mishawaka, Ind., the Sisters of St. Francis Health Services is a network of 13 growing hospital campuses in Indiana and Illinois is one of the largest health-care systems in the state. The system’s health-care ministry in Indiana was established in 1875. More information about SSFHS is at www.ssfhs.org.

About Anthem Blue Cross and Blue Shield in Indiana
Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Indiana is available at www.anthem.com.

Media Contacts:
Joe Stuteville-St. Francis
317-782-7986 (office)
Joe.Stuteville@ssfhs.org

Tony Felts-Anthem
317-287-6036 (office)
tony.felts@anthem.com

Toll-free number established for Anthem-insured patients

The Sisters of St. Francis Health Services Inc. recently announced a contract termination with Anthem Blue Cross and Blue Shield in Indiana effective Nov. 2. This is largely due to Anthem's lack of timely and accurate payment of claims reimbursement.

We know this causes concern and confusion to our patients, physicians and staff, and we are hoping to address these concerns with a toll-free telephone number, 1 (866) 576-3590.

Callers will be asked to provide their contact information, which will be forwarded to St. Francis insurance representatives who can answer their questions more directly and with more specific detail. As we are anticipating a high level of calls, our goal to respond to your questions within 24 to 48 hours.

You also can find answers to many common questions on our Q&A section at http://stfrancis-anthem.blogspot.com.

[updated phone number Oct. 24, 2008]

St. Francis health system launches Web site to assist Anthem patients

INDIANAPOLIS – The Sisters of St. Francis Health Services, Inc. (SSFHS) has established an informational Web site – http://stfrancis-anthem.blogspot.com – to keep Anthem Blue Cross and Blue Shield of Indiana patients informed of their health care options.

This new site provides updates and background information related to the recently announced contract termination with Anthem effective Nov. 2, 2008. A toll-free hotline also will be available on the site.

Patients are the paramount concern of the St. Francis health care system, which operates 13 hospitals in Indiana and Illinois.

SSFHS previously announced the contract termination in response to Anthem’s lack of timely claims reimbursement, a situation that has persisted since the fourth quarter of 2007.

St. Francis health system opts out of Anthem network Nov. 2

INDIANAPOLIS – The Sisters of St. Francis Health Services, Inc. (SSFHS) announced today (Oct. 13) that its contract with Anthem Blue Cross and Blue Shield of Indiana is set to end Nov. 2, 2008.

Reasons for the termination include Anthem’s lack of accurate and timely claims payment and the inability to secure contract terms comparable to other hospitals in the area, SSFHS officials said.

The termination will cover the following SSFHS hospitals and physicians:

St. Francis Hospital & Health Center (Indianapolis)

St. Francis Hospital & Health Center (Beech Grove)

St. Francis Hospital & Health Center (Mooresville)

St. Elizabeth Regional Health (Lafayette)

Home Hospital (Lafayette)

St. Anthony Medical Center (Crown Point)

St. Anthony Memorial Health Center (Michigan City)

St. Margaret Mercy Healthcare Center (Hammond)

St. Margaret Mercy Healthcare Center (Dyer)

St. Clare Medical Center (Crawfordsville)

Franciscan Physicians Hospital (Munster)

More than 300 physicians in the different SSFHS service areas

“SSFHS is a good partner that works closely with payers to resolve claims problems when they occur,” said Greg Yust, SSFHS vice president of managed care contracting. “We recently forged successful long-term agreements with Aetna, Humana, Saga more and CIGNA. The Anthem claims issues have been ongoing for more than a year with no progress whatsoever.”

St. Francis hopes to work out a new agreement with Anthem. In the event SSFHS is unable to reach an agreement, it will work continue to work with Anthem, patients and employers to limit the impact the contract dispute might cause.