Anthem Blue Cross and Blue Shield Contract Negotiation with MSK: What Members Need to Know
November 2024
Anthem Blue Cross and Blue Shield is currently in discussions with Memorial Sloan Kettering Cancer Center (MSK) to keep them in our care provider network through 2025 and beyond. We continue to work hard toward an agreement, and we remain optimistic one will be reached that maintains our members’ access to affordable care at MSK. Our current agreement with MSK for members covered by employer-based and Medicare Advantage plans expires at the end of this year, but MSK will remain in Anthem’s network until at least March 1, 2025. Anthem Medicaid members are not impacted by the current negotiations.
This is about healthcare affordability
Our negotiations focus on the prices that MSK will charge our members for care. MSK is a world-class cancer institute and is currently paid accordingly. In fact, Anthem currently reimburses MSK at rates at or above other national cancer Centers of Excellence.
Our negotiations focus on the prices that MSK will charge our members for care. MSK is a world-class cancer institute and is currently paid accordingly. In fact, Anthem currently reimburses MSK at rates at or above other national cancer Centers of Excellence.
MSK is currently asking for almost double-digit price increases each year for the next three years. This would send prices skyrocketing for New Yorkers and their employers. As just one example, under MSK’s proposed price increase, an already-expensive mastectomy would cost $19,345 more in 2027 than it does right now. These are increases that would be directly felt by our members and their employers.
We understand that, like all New York businesses, hospitals face cost pressures. That’s why we have offered reasonable price increases that keep MSK well-funded, are like those in place with other national cancer Centers of Excellence and would maintain access to affordable care at MSK.
Affordable healthcare is important. What good is a world-class care center if no one can afford it?
What Anthem members should do
Our members should continue accessing care at MSK as they have in the past. We remain confident an agreement will be reached that keeps MSK in our network for employer-based and Medicare Advantage health plans beyond March 1, 2025.
However, if an agreement can’t be reached and MSK chooses to leave our network, any member who begins receiving services prior to March 1, 2025, will be covered through their entire course of treatment.
It’s important to know that Anthem’s care provider network includes other National Cancer Institute designated Centers of Excellence right here in New York, including:
- NYU Langone’s Perimutter Cancer Center
- Montefiore’s Einstein Cancer Center
- Columbia University’s Herbert Irving Cancer Center
- Mt. Sinai’s Tisch Cancer Institute
Anthem always covers any medically necessary emergency services for our members no matter where they get care.
Anthem’s Network in New York
We are New York’s leader in building collaborative, innovative provider relationships. Anthem is proud that 172 of New York’s hospitals belonging to 24 health systems, nearly 10,000 of New York’s doctors, and 7,573 pediatricians participate in our members’ networks. Our provider partnerships are vital to helping us achieve high-quality, results-driven healthcare and improving the lives and health of the people and communities we serve.
Commitment to our members
We will keep working with MSK to try to reach an agreement that’s focused on access to quality, low-cost healthcare. We will update this site as we continue our efforts.
Frequently Asked Questions
MSK is saying that Anthem would not include MSK as an in-network provider starting on January 1, 2025. Is this true?
No. This is not accurate. New York State law requires that the parties abide by the terms of the existing agreement for two months after the contract ends. That means MSK will remain in the Anthem network until at least March 1, 2025, if no agreement can be reached.
Who is impacted?
Please note there is no immediate change to healthcare coverage for our Employer-covered members as Memorial Sloan Kettering is still in our provider network through at least March 1, 2025. We are working hard to keep them in our network beyond that date and we’re confident an agreement will be reached.
MSK has notified Anthem in New York that it will be leaving our Medicare Advantage network on January 1, 2025. MSK will remain in the Anthem network until March 1, 2025, but will not be part of the network after that date. This negotiation does NOT impact Medicare Supplement plans.
Anthem Medicaid, Essential Plan members, and ACA/Exchange members in New York are not impacted by these contract negotiations with MSK.
What should Anthem members do?
Nothing different. Anthem members should continue to access care at MSK or any of our other in-network cancer Centers of Excellence just as they have in the past.
Please also remember that Anthem offers special assistance and programs to help our members battling cancer. Members may call the number on their Anthem ID card for more information about these programs.
Where can members go for cancer care if MSK leaves Anthem’s network on March 1, 2025?
Because of our collaborative approach with New York doctors and hospitals, Anthem offers one of the industry’s most comprehensive care provider networks, including other cancer Centers of Excellence here in New York and throughout the country. You can find alternative providers in your plan by logging in to anthem.com, visiting the Sydney Health app, or by calling the Member Services number on your ID card.
Where can members go for information?
We will update this page as negotiations continue in the coming weeks and months. Please return here for updates or contact the Member Services Center at the phone number on your Anthem ID card.
What if I am currently receiving care at MSK facilities?
It is important to remember that MSK will stay in Anthem’s network through at least March 1, 2025, and we are optimistic that a new agreement will be reached.
What should I do if I need emergency medical care from MSK?
Anyone in need of emergency care should immediately go to the nearest emergency room or call 9-1-1. Anthem will cover emergency services for our members whether the hospital is in-network or not. It is important to remember that MSK will remain in Anthem’s network through at least March 1, 2025. After that date, Anthem employer-sponsored and Medicare Advantage members can still receive emergency care at Memorial Sloan Kettering.
What if I have more questions?
Anthem care guides are available to support impacted members who need help getting care. For more help, call Member Services at the number on your member ID card. Please check this site for updates about our efforts to reach an agreement with Memorial Sloan Kettering.
