Vanderbilt University Medical Center has cut a deal with Cigna to keep seeing Obamacare patients in Middle Tennessee. The region's largest hospital was just weeks from being out-of-network for Nashville-area residents who buy health insurance on the federal marketplace.
These negotiations between health care providers and insurers take months, going back and forth over how much will be paid for particular procedures and how chronic patients will be handled most efficiently.
Vanderbilt, which offers more specialty care than most hospitals in the region, still hadn't come to an agreement in recent weeks with Cigna and faced being off-limits to tens of thousands of people. Cigna is one of the two insurers that will offer Obamacare coverage next year in Middle Tennessee.
Hospital CEO Wright Pinson says Vanderbilt always wanted to serve those patients, which is why he continued working toward a solution.
"Our commitment to the population allowed us to negotiate some rates that we thought were satisfactory, although not necessarily the highest rates that we've ever gotten," he says.
While not disclosing the particular sticking points, Pinson credits Cigna for making some concessions so they could come to an agreement before it was too late. Open enrollment for Obamacare begins Nov. 1.
Last year, a similar last-minute deal was reached so that Saint Thomas hospitals would be in-network for Obamacare enrollees.
Pinson, at Vanderbilt, says he understands why patients become upset about the issue, adding that it's "unfortunate" that plans move around as much as they do from year to year.
Previously, Vanderbilt's in-network plan on Obamacare was BlueCross BlueShield of Tennessee, which no longer participates in the exchange for Nashville-area residents.