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Anthem Blue Cross/Blue Shield, Middlesex Hospital Reach Agreement

Although the contract terms won't be released, health care claims will be paid, including those submitted for services during the three days Middlesex was considered "out of network" for members.

 

Anthem Blue Cross and Blue Shield and Middlesex Hospital have reached a multi-year agreement on the renewal of their contract. As a result, Middlesex Hospital will rejoin Anthem’s networks as a participating provider immediately.  

Covered services provided by the hospital to Anthem members will resume on an in-network basis. Per the agreement of both parties, terms of the contracts will not be released.

Anthem and Middlesex Hospital have worked out an arrangement so that claims for Anthem members who received services from the hospital during the time the hospital was out of network will be paid under the member’s in-network benefit.

“We are pleased our members will again have in network access to Middlesex Hospital,” said David R. Fusco, President, Anthem Blue Cross and Blue Shield. “We are confident we have reached the right deal, including initiatives that support our collective efforts to improve quality and outcomes.”

According to Vincent G. Capece Jr., President & CEO of Middlesex Hospital, “We are pleased that Middlesex Hospital has been able to come to a multi-year agreement with Anthem Blue Cross and Blue Shield. For years, Anthem members have chosen Middlesex Hospital as their preferred hospital because they recognize the high-quality health care services the Hospital provides. This new agreement will ensure that Anthem members will continue to have access to these valuable health care services throughout Middlesex County.”

As part of the agreement, Middlesex Hospital’s reimbursement continues to be aligned with incentives designed to measure and improve health care quality and efficiency, as well as to improve patient safety. In addition, Anthem and Middlesex Hospital will collaborate on an accountable care model to effectively manage the patient population served by Middlesex Hospital and its affiliated physicians. 

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