The Columbus Dispatch

Nationwide Children’s, Anthem strike deal

Agreement to cover Ohio children on Medicaid

- Max Filby Columbus Dispatch USA TODAY NETWORK

Ohio kids on a Medicaid plan with Anthem Blue Cross and Blue Shield are now considered in-network when visiting Nationwide Children’s Hospital in Columbus, meaning the insurer will cover the cost of care.

The deal, announced late last week by the insurer, comes after months of unresolved negotiatio­ns that left Ohio kids on Anthem’s Medicaid plan outof-network when visiting the hospital. As of mid-april, around 5,600 kids in central and southeast Ohio were insured by Anthem’s Medicaid plan, a Nationwide Children’s spokespers­on told The Dispatch via email.

Before last week, Anthem was the lone Medicaid provider out of seven in Ohio that hadn’t reached a deal with Nationwide Children’s.

The lack of an agreement risked forcing children and their families to travel elsewhere in Ohio or even outside the state for care, hospital leaders previously said. Anthem pushed back on that narrative at the time, pointing to its network of more than 800 pediatrici­ans and 240 behavioral health providers in the greater Columbus area.

“We appreciate Nationwide’s willingnes­s to agree to contract terms that deliver access to care for those we serve and in a manner that is more sustainabl­e for the Ohio Medicaid program,” a statement from the insurer reads. “Anthem Blue Cross and Blue Shield is committed to providing access to highqualit­y healthcare that improves the health of the people we serve.”

Medicaid is the government insurance program that covers people with limited income and those on disability. There are at least 1.3 million Ohio kids on Medicaid, according to the Ohio Children’s Hospital Associatio­n.

A breakdown in negotiatio­ns spilled into public view in March after Dr. Rustin Morse, chief medical officer at the hospital, wrote a guest column in The Dispatch’s opinion section detailing the potential impact a lack of an agreement could have. Morse at the time wrote that Anthem had declined to enter into an agreement with the hospital that was nearly identical to ones it had with six other Medicaid providers.

Morse on Thursday praised the agreement between Anthem and Nationwide Children’s.

“Nationwide Children’s goal is to provide care for any child who needs it, and this agreement helps us achieve that goal for children in Ohio covered by Medicaid,” Morse said in a prepared statement.

“We appreciate Anthem’s shared commitment to ensuring children everywhere have access to care that will help them achieve their best health outcomes.” mfilby@dispatch.com @Maxfilby

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