Ballad Health provides update on negotiations with Cigna Healthcare

New agreement with Cigna expands access in Appalachian Highlands

Ballad Health announced today it has reached an agreement with Cigna Healthcare for new agreements that ensure in-network access for consumers covered by Cigna to all Ballad Health hospitals, facilities and physicians. These new agreements apply to Cigna Commercial plans (employer and individual coverage), Cigna Connect (Marketplace Exchange) and Evernorth (behavioral health). Ballad Health has previously announced that the Cigna Medicare Advantage product has also been extended, ensuring access for seniors who have chosen Cigna products.

Any care currently being provided, and any newly scheduled care or procedure, will be provided as “in-network” without any disruptions.

As an additional outcome of the current negotiation, all hospitals and physicians previously associated with Wellmont will now be considered “in-network” for the Cigna Connect (Marketplace Exchange) product effective March 1, 2025, which expands access to more medical providers available to the community. Currently, they are not considered “in-network” for the Cigna Connect product, as they have never had an agreement with Cigna for this particular product. This agreement includes all legacy Wellmont hospitals in Tennessee – Holston Valley Medical Center, Bristol Regional Medical Center, Hawkins County Memorial Hospital, Hancock County Hospital and Greeneville Community Hospital. Ballad Health hospitals and physicians in Virginia were not affected by this negotiation.

With this negotiation concluded, Ballad Health has executed agreements with all major insurers, including, but not limited to, Blue Cross/Blue Shield of Tennessee, Anthem/Elevance, United Healthcare, Humana, and now, Cigna. These various agreements cover numerous plans, including Medicare Advantage, Commercial and coverage provided through the marketplace exchange.

As a not-for-profit health system, Ballad Health invests all earnings back into the communities it serves. Since the 2020 pandemic, national healthcare manpower labor shortages have put a major strain on access to care throughout the nation, which has been felt locally through longer wait times and other service issues. Ballad Health has taken steps to invest heavily in the clinical workforce to help ease the strain, with these investments exceeding $200 million annually. The result of these and other decisions have led to Ballad Health currently posting a nursing turnover rate materially below the national average – an important step toward recovering the workforce. In the first quarter of the current fiscal year, despite increases in patient volume, Ballad Health posted an operating loss $17 million greater than its operating loss in the prior year. The net increase in salary, wage and benefit costs for the quarter versus the prior year, due to the investment in nurses and clinical staff, amount to more than $28 million for the quarter alone – easily consuming Ballad Health’s operating margin. Hire-in wages for nurses have doubled since 2022, and all care nurses have received material wage adjustments to reflect the increase in the wages for new hires.

In its negotiations with insurers, Ballad Health has asked that each insurer responsibly contribute to the cost of sustaining nursing and clinical staff – putting insurance premiums where they belong – in the hands of the people who provide the care. Ballad Health provided detailed evidence of the investment in nursing and clinical wages and benefits to each insurer during negotiations, and the insurers used this information to inform their negotiations. Ballad Health is grateful that each insurer ultimately agreed to take part in investing in its clinical staff. It was the right decision and a good investment in the region.

With these negotiations complete, Ballad Health looks forward to working with each insurer to ensure patients receive the care their physicians determine necessary, and to continue to improve high-value care throughout the region.