Memorial Sloan Kettering Cancer Center and health insurer Anthem Blue Cross and Blue Shield have reached a deal on payment rates, maintaining coverage of cancer services for thousands of patients in New York, the organizations said Monday.
The agreement comes days before an existing contract between the Upper East Side oncology hospital and the insurer was set to expire. If the companies failed to reach an agreement before Jan. 1, patients at MSK could have been forced to pay more expensive rates for cancer services or seek care elsewhere.
The deal enables MSK “to deliver the best possible cancer outcomes for our patients and allows 22,000 active patients to continue receiving uninterrupted care,” Dr. Selwyn Vickers, the hospital’s president and CEO, said in a statement.
The multi-year deal allows MSK to remain a part of Anthem’s network, meaning that patients enrolled in Anthem’s employer-sponsored health plans as well as Medicaid and Essential Plan options will have access to insurance coverage at MSK’s flagship hospital and outpatient locations across the city, Long Island and Westchester. MSK and Anthem did not disclose specific details about payment rates, citing confidentiality agreements.
Memorial Sloan Kettering and Anthem have been negotiating the details of the contract since 2022. The cancer center, which brought in $7.4 billion in revenue last year, has demanded higher rates, stating that Anthem pays MSK 34% less than its peer hospitals in Manhattan. But Anthem said MSK’s requested rates were too steep; Kersha Cartwright, a spokeswoman for the insurance company, previously told Crain’s that the hospital was demanding rate increases that were four times the annual rate of inflation.
The payment battle came to a head this summer when Memorial Sloan Kettering began sending letters to patients enrolled in Anthem’s health plans to let them know that they could lose access to in-network coverage after Jan. 1. Patients – who have increasingly been thrust in the middle of contract disputes between hospitals and insurance companies – were left wondering whether they’d be forced to find new doctors or pay out of pocket for cancer services in the new year.
The deal with Anthem marks the second high-profile payment battle between MSK and an insurance company this year. The cancer hospital warned patients insured by Cigna last December that they might lose access to coverage, prompting more negotiations and a deal between the two parties earlier this year.
