St. Vincent’s and Anthem have come to an agreement for Anthem’s individual health insurance network. This is a large expansion of the Pathway X HMO/POS network. Now all Anthem individual policy holders both on and off the exchange will have access to utilize St. Vincent’s medical services.
When the Affordable Care Act was passed, insurance companies looked for options to try to control health care cost. The number one option was limited network providers. By limiting network providers, they were able to negotiate reimbursement rates.
The expansion of the Pathway X network to include St. Vincent’s shows that Anthem understands the value of giving their members choices. This also shows that St. Vincent understands that they need their Anthem members. Both sides came to the conclusion that they need one another.
The health care/insurance markets will continue to adapt to the ACA through working together.