Nationwide Children's, Anthem strike deal to cover kids: Here's what you need to know

Max Filby, The Columbus Dispatch
Updated ·2 min read
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Apr 14, 2023; Gahanna, Ohio, United States; Emily Crawford shows the scars from surgery on her four month old baby Sage Crawford in their home. Emily has had to navigate finding a new health plans while caring for Sage through multiple heart surgeries, the medicaid that previously covered Sage through Anthem does not cover treatment at Nationwide Childrens Hospital. Mandatory Credit: Brooke LaValley/Columbus Dispatch

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 Thursday by the insurer, comes after months of unresolved negotiations that left Ohio kids on Anthem's Medicaid plan out-of-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.

Read More: Anthem Medicaid dispute with Nationwide Children's jeopardizes healthcare access for thousands

Before this 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 high-quality healthcare that improves the health of the people we serve."

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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

This article originally appeared on The Columbus Dispatch: Nationwide Children's and Anthem strike deal to cover kids' care