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CoxHealth officials say the health care system has been unable to negotiate in-network support with Centene.
SBJ file
CoxHealth officials say the health care system has been unable to negotiate in-network support with Centene.

CoxHealth fails to reach Medicaid agreement with Centene

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Last edited 1:09 p.m., Jan. 6, 2023

CoxHealth has reached agreements with two of the three insurance companies that administer managed Medicaid programs statewide after the state recently required hospitals to renegotiate their contracts.

MO HealthNet Managed Medicaid products offered by UnitedHealthcare Community Plan and Healthy Blue/Anthem will remain in network at CoxHealth, according to a news release.

"Unfortunately, after much negotiation, we were unable to reach an agreement with Centene, which provides the managed Medicaid plan Home State Health," officials said in the release. "We are aware of the unfortunate impact this change will create for children and families, and that is why CoxHealth made every effort to reach a resolution. We offered Centene rates on par with those we offer other managed Medicaid insurance companies, but Centene chose not to accept those rates."

In a statement provided to Springfield Business Journal, officials with St. Louis-based Centene Corp. (NYSE: CNC) said "we are disappointed that an agreement has not been reached with the health system."

"We are taking all steps necessary to mitigate the impact of this network change on our members," the statement reads. "Over the past 12 months, we have successfully recontracted with 134 hospitals across Missouri, and if it is not possible to reach an agreement with CoxHealth, we have a comprehensive process in place to transition our members to alternative providers in the Home State Health network. We will work diligently to ensure the transition to new providers is as seamless as possible for our members and they do not experience delays in receiving the health services they need."

CoxHealth officials said in the release the health care system is committed to "contracting with Centene at the fair rates we have offered." However, there are no active negotiations underway.

Patients will have to go out of CoxHealth's network for the Show Me Healthy Kids program, which provides care for children in need and is the sole insurance provider for children in state custody, including youth in foster care. Officials with the health care system said children in the Show Me Healthy Kids program would still have access to care in Springfield at Mercy and Jordan Valley Community Health Center.

"We are working with our community partners at both organizations to ensure that these children continue to have access to care," officials said in the release. "We believe that if Centene’s Home State Health is required to be the sole insurance provider for children in foster care, they should have agreements with major health systems in our region."

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