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Updates About Negotiations with Aspirus Health

September 15, 2022
September 2022

What's Happening?

Aspirus Health has notified Anthem Blue Cross and Blue Shield in Wisconsin that it intends to leave our members' care provider network at the end of this year unless Anthem agrees to let Aspirus dramatically increase costs for our members and employers, in most cases 20 percent more. Aspirus has also informed us that they will not accept Anthem's Medicare Advantage and Medicaid members next year. We cannot agree to restricted healthcare access for our Medicare Advantage and Medicaid members, nor can we ask North Central Wisconsin residents and businesses to pay up to 20 percent more for healthcare.

We understand that access to Aspirus Health is important. That's why we continue to work to keep Aspirus in our all of members' plans while protecting affordability.

We value our care provider relationships, and we believe doctors and hospitals should be paid fairly for their services. We will continue to work to find common ground with Aspirus Health and reach a fair and reasonable agreement.

Frequently Asked Questions
Q: Who will be impacted if Aspirus Health leaves Anthem members’ plan?

Please note, there is no immediate change to healthcare coverage for our members as Aspirus Health remains in our members' care provider network through the end of this year, and we continue to work toward keeping them in next year and beyond. However, if Aspirus Health chooses to leave Anthem's network beginning January 1, 2023, all Anthem members receiving healthcare services from Aspirus Health doctors, hospitals and other care locations will be impacted.

Q: Are you concerned Aspirus Health will eventually leave Anthem’s network?

We are committed to resolving the issues with Aspirus Health.

It's unfortunate that Aspirus is seeking to limit healthcare choices for North Central Wisconsin consumers and increase costs so dramatically, but we remain hopeful that a compromise can be reached. In the end, we believe we share a mutual interest to serve the community. As we work tirelessly toward a mutual resolution, Anthem will keep our customers, our members, and our provider partners up to date on our progress.

Q: Aspirus and Anthem have worked together for a long time with no issues. What changed?

That's correct. We're proud of the decades-long collaborative relationship we've had with Aspirus as we work together to serve North Central Wisconsin communities. Unfortunately, the tone and tenor of our relationship changed about a year ago.

Q: How will members currently being treated for cancer or other ongoing illnesses be affected?

We know this is especially difficult for people in situations like this, that's a big reason we worked hard to avoid this disruption and why we remain committed to trying to reach an agreement that will keep Aspirus in our network. Again, it is important to remember that Aspirus Health will remain in the Anthem network through December 31, 2022. Anthem will make sure members who need ongoing care continue to have access to needed care after that date.

Q: What should members do when they need emergency medical care from Aspirus Health?

It is important to remember that Aspirus Health will remain in the Anthem network through at least December 31, 2022. A hospital's emergency medical services do not require pre-authorization, regardless of where they are delivered. Anyone in need of emergency care should immediately go to the nearest emergency room or call 9-1-1. Coverage will be provided according to the member's policy benefits and is subject to in-network cost shares.

Q: What if I have further questions?

Please check this site for updates on our work to resolve these issues with Aspirus Health or call the Member Services number on the back of your Anthem ID card.