Mercy Health May Be Out-of-Network for Patients with Cigna Commercial Insurance Plans

WARREN COUNTY, OH -- 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 prescription medication costs, more than 13% increases in supply costs, and more than 5% increases in 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 becoming increasingly prevalent, leading to significant administrative burdens for health care providers and significant delays in patient care.

Despite 2024 revenues of more than $247 billion—an increase of 27%—Cigna refuses to offer Mercy Health fair rates, forcing patients to choose between finding new providers or paying out-of-network rates.

“As providers of high-quality, compassionate care, we are committed to serving every patient who comes through our doors, and Cigna’s refusal to help ensure in-network access for our patients is incredibly disappointing,” said Leonardo Lozada, MD, Chief Clinical Officer, Cincinnati. “Our patients deserve access to care when needed, and reimbursement to cover growing costs to provide care is part of the equation. We implore Cigna to reimburse our providers fairly for the care they provide every day. We urge patients to call Cigna on the number on the back of their insurance card and let them know how important it is to keep Mercy Health in their network.” 

To avoid 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, which would allow approved patients 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.

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