Anthem Negotiations with St. Joseph Hospital in New Hampshire: What Our Members Need to Know
December 30, 2024Here’s What’s Happening
Anthem Blue Cross and Blue Shield in New Hampshire (Anthem) and St. Joseph Hospital are negotiating a new agreement to keep St. Joseph Hospital in our network and improve healthcare affordability for Granite Staters.
Our current contract with St. Joseph Hospital ends December 31, 2024. However, even if we’re not able to reach a new agreement before that time, services and care received at St. Joseph Hospital and from its physicians, providers, and facilities will continue to be paid as in-network through March 1, 2025 for individuals in employer-based, individual, and Federal Employee Program plans. That means that Anthem members may continue to seek care at St. Joseph Hospital as they have in the past while we continue to work in good faith with St. Joseph Hospital to reach an agreement before March 1, 2025. Importantly, this does not impact members in Medicare Advantage plans.
Negotiating on Behalf of New Hampshire Consumers and Employers
St. Joseph Hospital is already one of the most expensive hospitals in New Hampshire. Now, it’s demanding to drastically increase the prices it charges patients covered by Anthem. This would mean much higher out-of-pocket costs for Anthem members. These higher costs would hit employers and their employees hard as well. More than half of Anthem members in New Hampshire are covered by employers who directly pay their employees’ healthcare bills. That means that New Hampshire employers and employees would feel the burden of these price increases – hampering employers’ ability to raise pay, offer benefits, and hire new workers, and increasing employees’ cost shares for healthcare services.
Our Members Are Our First Priority
We know this is concerning for our members and our community’s employers. It’s important to know that services and care at St. Joseph Hospital will continue to be paid as in-network through at least March 1, 2025. We are working hard to reach a long-term agreement that extends those benefits well beyond that date.
We’re also taking steps to make sure our members have access to care in the event St. Joseph Hospital chooses to leave our network. This includes ensuring that our members currently receiving treatment at St. Joseph Hospital for serious and complex conditions may continue care with their current provider for a limited time. For our other members, Anthem’s extensive care provider network in southern New Hampshire also includes many other high-quality health systems and physician practices. We will ensure our members have access to the care they need. Please see below for more information.
Our Offer: Fair Payment Rates
Anthem has offered reasonable and fair payment that is in line with other New Hampshire health systems. So far, St. Joseph Hospital has refused these offers.
FREQUENTLY ASKED QUESTIONS
Will you reach an agreement?
We hope so. We’re working in good faith to reach a new long-term contract that keeps St. Joseph Hospital in our network for years to come and ensures our members have access to care at their doctors and hospitals while improving affordability. Please continue to check this site for updates.
We hope so. We’re working in good faith to reach a new long-term contract that keeps St. Joseph Hospital in our network for years to come and ensures our members have access to care at their doctors and hospitals while improving affordability. Please continue to check this site for updates.
What should Anthem members do?
While our members will continue to have care at St. Joseph Hospital paid as in-network at least through March 1, 2025, we recommend that members consider scheduling or re-scheduling elective care at alternative in-network providers. Contact Member Services at the number on the back of your Anthem ID card for assistance. Please continue to check this site for updates.
While our members will continue to have care at St. Joseph Hospital paid as in-network at least through March 1, 2025, we recommend that members consider scheduling or re-scheduling elective care at alternative in-network providers. Contact Member Services at the number on the back of your Anthem ID card for assistance. Please continue to check this site for updates.
Which hospitals/facilities are impacted?
Anthem members in individual, employer-sponsored, and Federal Employee Program plans receiving healthcare services from St. Joseph Hospital, its doctors, and other care locations would be affected if St. Joseph Hospital chooses to leave our network. Medicare Advantage members are not affected.
Anthem members in individual, employer-sponsored, and Federal Employee Program plans receiving healthcare services from St. Joseph Hospital, its doctors, and other care locations would be affected if St. Joseph Hospital chooses to leave our network. Medicare Advantage members are not affected.
This includes the following locations:
- St. Joseph Hospital in Nashua, NH
- All other St. Joseph Hospital/Covenant Health facilities and physicians in New Hampshire, including:
- All primary and specialty care practices in Hudson, Merrimack, Milford, and Nashua
- Diagnostic imaging locations in Milford and Nashua
- Laboratory service locations in Hudson, Milford, and Nashua
- Rehabilitation service locations in Hudson, Merrimack, Milford, and Nashua
- Senior Behavioral Health Unit at St. Joseph Hospital in Nashua
- Urgent care at Milford Medical Center in Milford
What if I’m currently being treated at St. Joseph Hospital?
Please note at this time there are no immediate changes for our members. We know this is especially concerning for our members currently receiving care at St. Joseph Hospital. That’s why we’re taking steps to help in the event St. Joseph Hospital leaves our network. If you are a member receiving treatment for a serious or complex condition that will continue past March 1, 2025, please contact our Member Service Center at the number on your Anthem ID card. You may be able to continue your care at St. Joseph Hospital for a limited time after that date if you are receiving certain types of care.
What should I do if I need emergency medical care from St. Joseph Hospital?
A hospital’s emergency medical services do not require pre-authorization, regardless of where they are delivered. Anyone in need of emergency care should go to the nearest emergency room or call 9-1-1. Coverage will be provided according to your policy benefits and is subject to in-network cost shares.
Where can I go for care if St. Joseph Hospital leaves Anthem’s network?
Anthem offers a broad network of hospitals and physicians that includes every other hospital in New Hampshire in most plans. In addition, we have a broad network of physician practices in the area.
Nearby hospitals:
- Southern New Hampshire Medical Center in Nashua, NH
- The Elliot Hospital in Manchester, NH
- Parkland Medical Center in Derry, NH
- Catholic Medical Center in Manchester, NH
Nearby physician practices:
- Derry Medical Center, Derry, NH and other locations
- Dartmouth Hitchcock Clinics Nashua, Nashua, NH and other locations
- Foundation Medical Partners, Nashua, NH and other locations
Members can use the Sydney Health mobile app or anthem.com to find doctors near them. Members can also contact Member Services through Sydney Health or by calling the number on their Anthem ID card for assistance finding a new provider in their area.
Using out-of-network facilities and physicians will lead to higher costs for members, which is why we always encourage members to seek care from in-network providers.
What if I have further questions?
Please check this site for updates, or call the Member Services number on the back of your Anthem ID card.