Fort Wayne, Ind. – June 12, 2025 – As the July 31, 2025 deadline to finalize a new agreement with Anthem approaches, Parkview Health is urging Anthem to take meaningful action to resolve critical issues blocking progress:
- Access to care for seniors with Medicare Advantage plans at fair reimbursement.
Anthem simply does not cover the same services or provide the same payment as when Medicare seniors are covered directly by Medicare. These delays in care and denials of coverage, which traditional Medicare would have covered, harm patients and lead to unfunded care that employers in our community must subsidize.
Anthem and other commercial insurers have made billions off the backs of seniors, healthcare providers and the federal government, and must come to the table and agree to pay for the care seniors need.
- Fair rates for services provided in non-hospital settings that are reimbursed typically at 60% of hospital-based care. Parkview is committed to expanding its network of low-cost ambulatory care sites but needs to be paid fairly when procedures are safely moved out of hospital settings.
Anthem’s latest proposal continues contract language that permits delayed payments, retroactive denials, and excessive prior authorization requirements that prevent patients, particularly seniors, from getting the care their physicians order. In addition, Anthem proposes to reimburse Parkview for care provided to Medicare Advantage members at rates below Medicare. Anthem’s underfunding of government patients simply pads their profits by shifting costs to local employers and patients.
“These issues are deeply connected. Anthem is enforcing administrative policies that delay and deny care, especially for seniors,”said Dr. Jason Row, chief value transformation officer, Parkview Health. “We cannot continue a partnership that jeopardizes access and quality, and shifts costs to local employers.”
Over the past five years, Parkview has taken aggressive steps to make care more affordable, absorbing over $1.1 billion in rate reductions from commercial insurers. In the current negotiation, Parkview has offered lower commercial hospital rates than it currently receives. This means Anthem would pay Parkview less for services in 2028 than it did in 2020. Despite this, Anthem has not addressed the fact that Medicare Advantage payments are significantly below industry standards, shifting costs to employers for government patients.
“Unless Anthem returns to the table with fair, workable solutions on both patient access and rates, we will have to consider all options, including exiting their Medicare Advantage network,” Dr. Row added. “That is not something we want to do, but Anthem’s lack of urgency and unwillingness to negotiate in good faith gives us no other choice.”
Parkview remains fully committed to avoiding disruptions in patient care, if Anthem shares a reasonable proposal. However, Parkview has proactively prepared resources to support patients in transitioning their care should Anthem choose to exclude Parkview from its network. This includes working with other Medicare Advantage plans that patients may choose to switch to and offering a best-in-market commercial plan – Signature Care EPO Plus – at rates 25% below those offered in Anthem open network products.
What patients can do
For now, and until July 31, 2025, patients covered by Anthem should continue seeking care as usual at Parkview hospitals, facilities, and physician offices.
Patients with Anthem may consider the following steps to ensure that Parkview remains in Anthem’s network:
- Call Anthem using the number on the back of your insurance card and tell them it’s important to keep Parkview in its network.
- Those who have employer-sponsored insurance can talk to their HR or benefits manager about selecting a plan that includes Parkview in its network next year.
Please visit parkview.com/anthem for additional information and updates, or call Parkview’s dedicated Anthem hotline at 260-215-6400.