Saint Thomas Health and Cigna have reached an agreement that will put the not-for-profit health system in some 2017 health insurance plans sold on the Obamacare exchange.
Saint Thomas Health was excluded from networks in individual health plans sold on the exchange after UnitedHealthcare decided to leave the state and BlueCross BlueShield of Tennessee exited the greater Nashville market. The two remaining carriers, Cigna and Humana contracted with TriStar Health, leaving Saint Thomas Health, Nashville General Hospital at Meharry and Vanderbilt University Medical Center out of plans sold on the exchange.
In a win for patients worrying about whether they would have to switch providers, Saint Thomas Health will be in-network in a line of plans called Cigna Connect starting Jan. 1. The in-network coverage will include Saint Thomas Medical Partners as well as the health system’s hospitals.
“I’m truly proud of this example of the community coming together. We’re very excited to take care of our patients… without interruption,” said Fahad Tahir, CEO of Saint Thomas Medical Partners.
Saint Thomas Health worked with business and community leaders to launch negotiations to get into a network as some patients fretted about having to transfer delicate treatment plans to new physicians.
Tatum Allsep, executive director of Music Health Alliance, said the agreement is an answered prayer.
“Oh my gosh, that is awesome,” said Allsep. “I’d hoped, I’d hoped so much. This is the same type of shock when (I heard) BlueCross pulled out of the market.”
The agreement helps relieve some confusion. Since BCBST is still selling plans in five regions of the state, shoppers in those counties would have had access to Saint Thomas Health — even though people in the greater Nashville area did not.
Cigna Connect plans will cover Saint Thomas Health and TriStar Health for people living in Cheatham, Davidson, Montgomery, Robertson, Rutherford, Sumner, Trousdale, Williamson and Wilson Counties. For those people who live in areas served by BCBST, Saint Thomas Health is still a covered health system.
“This was not a win for Saint Thomas,” said Tahir. “It was a win for the community.”
TriStar has been Cigna’s go-to health system on the exchange in previous years but the insurer wanted to respond to concerns in the community, said Amy Szable, Cigna spokeswoman.
“We are continuing our long-standing relationship with HCA/TriStar Health and we are confident that our individual customers will continue to receive quality care and service through this partnership,” said Szable. “We thank both TriStar Health and Saint Thomas Health for working with us to address our community’s concerns and to help improve health and well-being in Middle Tennessee.”
The network updates are not yet visible on healthcare.gov, and may not be for some time, said Tahir. Saint Thomas Health has a webpage that is searchable by county for people looking to see if their provider is covered.
Allsep, who has been working this week to help some BCBST members find new doctors to see, credited Tahir for seeing the negotiations through to an agreement.
“Nashville is so fortunate to have Fahad Tahir on our side,” said Allsep. “No one – no one fought like he fought to bring access to healthcare to Nashvillians like he did.”
Open enrollment begins on healthcare.gov on Nov. 1.