Jefferson Health is now out-of-network for people with employer-based insurance from The Cigna Group, because the two organizations were unable to negotiate a new contract.
The change, which took effect Saturday, increases health care costs for patients insured by Cigna. Jefferson Health, the largest health system in the Philadelphia region, has 32 hospitals in Pennsylvania and South Jersey and many other outpatient facilities.
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Jefferson and Cigna each pledged to continue talks in hopes of reaching a new contract.
"We understand that this news may cause concern, and we want to reassure our patients that we remain committed to providing high-quality care," Jefferson said in a statement. "We continue to negotiate in good faith with Cigna to reach a resolution that is fair and sustainable for our patients, providers and community."
Emergency care at Jefferson's hospitals will remain in-network for Cigna members, Jefferson said. Some Cigna members may qualify for transition of care programs that will maintain their in-network benefits. Many Cigna plans have out-of-network benefits that will allow members to continue accessing Jefferson's providers, Jefferson said. But out-of-network coverage typically is more expensive than in-network coverage.
People with Medicare Advantage plans through Cigna are not impacted by Jefferson and Cigna failing to reach a new deal.
Jefferson said they were unable to reach a new deal, because Cigna's reimbursement rates have increased by about 3% since 2020. But it said the Hospital Wage Index, which shows hourly labor costs, has gone up by 20% in that time, and the price of medical supplies and operations continues to rise.
Jefferson has been part of Cigna's network for over 20 years.
Cigna said Jefferson's demands for higher reimbursement rates would make in-network coverage more expensive to Cigna members.
"Unfortunately Jefferson Health is choosing to leave our network due to their unreasonable demands for rate hikes that would raise health costs for the people we serve," Cigna told the Philadelphia Business Journal. "We will continue to negotiate with Jefferson Health to reach a fair agreement that will keep health care affordable for patients."
Jefferson said it was "committed to fair and sustainable partnerships" in a video linked to its statement, noting it had reached contract agreements with all the other insurance providers it works with.
Last month, Main Line Health and Cigna negotiated an agreement just before their deal expired on Feb. 15, keeping the suburban Philly health system in network.