As of April 1, 2025, Mercy Health may be out-of-network for patients with Cigna commercial insurance plans. This follows months of negotiations for a fair contract that reimburses the costs for high-quality care to patients. Cigna’s reimbursements – already substantially less than other payers – have not increased in key markets since 2019 and are overwhelmingly inadequate to account for the rising cost of providing health care to the communities served by Mercy Health.
Like all health care providers in the United States, Mercy Health faces significant inflationary, labor and supply cost challenges. The American Hospital Association (AHA) and Kaufman Hall reported industry-wide cost increases over the last several years, including 15.2% increases in costs for prescription medications, more than 13% increases in supply costs and more than 5% increases for labor costs.
While costs continued to rise, hospital prices increased just 2.6%, yet health insurance premiums rose 6.7%, according to the AHA. Denials and delays from insurance providers like Cigna are more and more prevalent, leading to significant administrative burdens for health care providers and significant delays in care for patients.
Despite 2024 revenues of more than $247 billion – an increase of 27%, Cigna refuses to offer fair rates to Mercy Health forcing patients to choose between finding new providers or paying out-of-network rates.
“For 170 years, Mercy Health has served as the trusted health care provider in this region with a focus on ensuring access to quality care to all in need,” said Dr. James Tita, chief clinical officer, Mercy Health – Toledo. “It is incomprehensible that Cigna refuses to fairly reimburse providers while continuing to reap substantial profits, funded by both patients and employers. We encourage patients to contact Cigna at the number on the back of their insurance card and express how crucial it is for Mercy Health to remain in network.”
To avoid any care disruptions, Mercy Health is working with patients individually to reschedule April appointments and procedures as schedules allow.
Certain conditions, such as care for chronic or complex illnesses, may be eligible for Continuity of Care that would provide approved patients the opportunity to continue seeing their current care team at in-network rates, even if Mercy Health is forced out of the Cigna network. Patients can work with their providers to request a Continuity of Care provision from Cigna, though Cigna alone will decide whether to approve or deny the request.
More information can be found at www.mercy.com/cigna-updates
Submitted by: Erica Blake, Mercy Health Director, Public Relations & Communications
