Horizon Blue Cross Blue Shield of New Jersey announced Thursday that hospitals part of Hackensack Meridian Health, the state’s largest hospital system, will no longer be considered in-network providers.
For the past year, the insurer and hospital system have been working to reach a new agreement to stay in network, but Hackensack Meridian Health “has decided to terminate its hospitals from the Horizon Hospital Network,” said Thomas Wilson, a Horizon spokesman.
It’s unclear exactly how many patients across New Jersey will be affected by the change, which is expected to go into effect June 1, Wilson said.
Hackensack Meridian Health physician groups, such as primary care and specialty physician practices, are not included in the termination and will remain in-network. The decision to terminate also does not affect members covered by a Braven Health, Medicaid or Medicare policy, according to Horizon.
While both parties said Thursday there remains some hope for reconciliation, the two remain at odds over what they consider fair pricing and reimbursement.
“We have been and remain committed to reaching an agreement but must receive fair care reimbursements from Horizon to continue to invest in the care, medical technology, and locations that the local communities we serve rely on and expect,” said a Hackensack Meridian Health spokesperson in a statement to NJ Advance Media.
“Horizon’s proposal includes inadequate reimbursement rates and demands significant changes to previously agreed-upon contract terms. HMH remains committed to working with Horizon to reach a mutually beneficial agreement prioritizing high-quality patient care and access,” the spokesperson said.
Meanwhile, Horizon pointed the finger at Hackensack Meridian Health, arguing the hospital system has failed to control rising prices.
“Over the past 5 years, HMH’s prices have increased by more than the rate of inflation and HMH is already among the most expensive hospital systems in New Jersey. Horizon is offering a fair and reasonable price increase, but HMH is demanding an increase that is much higher than the rate of inflation,” said Wilson, Horizon spokesman.
Hackensack Meridian Health is the state’s largest health system with 18 hospitals and over 500 patient care locations, including ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, according to its website. The hospital system serves close to 2 million patients annually at its facilities.
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NJ Advance Media staff writer Karin Price Mueller contributed to this report.
Jackie Roman may be reached at jroman@njadvancemedia.com.
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