After months of negotiation with Anthem Blue Cross Blue Shield (BCBS), Mercy has provided written notice to end its contracts with Anthem in the state of Missouri. These contracts include all commercial, Medicare Advantage, Affordable Care Act (ACA) marketplace, managed Medicaid plans (Healthy Blue) and HealthLink (which falls under the Anthem BCBS umbrella).
“Our focus remains on safeguarding our patients and ensuring they receive the low-cost, high- quality care they deserve with insurance coverage that provides the greatest amount of protection for their health,” said Dave Thompson, Mercy’s senior vice president of population health and president of contracted revenue. “We know this news will be concerning for hundreds of thousands of Mercy patients with Anthem BCBS. We will continue to negotiate in good faith with Anthem in hopes of avoiding any disruption to our patients at the end of the year – particularly those patients in need of prolonged, coordinated care. However, patients and employers considering which health plans to purchase for 2025 should consider whether Mercy, the largest health system in the state, will be in the plan they purchase.”
Mercy hopes to remove much of the red tape that makes it increasingly difficult for patients to navigate Anthem’s system and creates a burden and barrier for patients to receive care when it’s medically necessary.
“These technicalities disrupt patient care and, in some cases, can be life threatening. They are administrative tasks dictated and mandated by Anthem, and they are a barrier to timely, appropriate patient care and can shift the cost of health care away from the insurance provider to those less able to afford it – our patients,” Thompson said. “Our patients have enough to worry about as they are often in the middle of a personal health care crisis. They shouldn’t have to worry about whether their insurance company will approve their coverage. They should be able to solely focus on their health and the health of their family members.”
While Mercy and other organizations providing patient care face the burden of rising costs, managed care companies are reaping enormous profits. In June 2024, Elevance Health, the corporate name for Anthem, reported a 24.12% increase in its year-over-year net income to $2.3 billion and a 24.29% increase in its year-over-year net profit margin. In stark contrast, Mercy’s average cost per inpatient stay for commercially insured patients is 27% below the average for all hospitals in the state and outpatient care for that same population is 16% below the average.
As a nonprofit health system, Mercy provided more than half a billion dollars in free care in the most recently available year, fiscal year 2023. This free care includes traditional charity care, unreimbursed Medicaid and other community benefits.
“The cost of providing actual care for patients has risen significantly due to inflation, but Anthem has not kept pace with those rising costs when it comes to reimbursing us for the care we provide to our communities,” said Thompson. “It’s unreasonable for the insurer to increase its premiums to patients and employers and increase its profits while expecting those of us providing health care directly to patients daily to bear the brunt of the higher cost for providing that care.”
Mercy will remain in network for medical services with Anthem through the end of the year and will move out of network with Anthem on Jan. 1, 2025, unless a new agreement is reached. This notice does not impact Mercy retail pharmacy services which will allow Mercy Pharmacy’s retail locations to continue serving Anthem patients with their current in-network coverage.
“We’re innovating to improve access to care while achieving top performance in quality and safety. We are also keeping our costs significantly lower than other health systems,” Thompson added. “Managed care companies can and should support this work to give patients access to medically necessary care and incentivize those who provide effective care and reduce the cost burden to the health care system. We want specific provisions from Anthem to support this work and correct issues our patients have with denials and red tape.”
Mercy encourages patients to share their concerns with Anthem by calling the number on the back of their health insurance cards or by calling Anthem at 1-800-331-1476 to make their voices heard.
Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized care and one of the nation’s largest and highest performing Accountable Care Organizations in quality and cost. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children’s, orthopedic and rehab)
hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and 50,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In fiscal year 2023 alone, Mercy provided more than half a billion dollars of free care and other community benefits, including traditional charity care and unreimbursed Medicaid.
Mercy Southeast will bolster its leadership team with the addition of Bryan Buckley as the new vice president of ancillary services.
Starting this month, Buckley will oversee a variety of services including laboratory, rehabilitation, imaging, public safety, environmental services and food services, among others.
Buckley brings a wealth of experience to Mercy Southeast, with 16 years as a registered nurse specializing in critical care and emergency department settings. Since 2017, he’s been in leadership positions, overseeing various services including critical care, medical-surgical, vascular access, rapid response, and inpatient and outpatient wound care.
“Joining Mercy – renowned for its exceptional customer service, care quality, and patient experience – was a significant draw for me,” Buckley said. “I’m excited to delve deeper into the organization, contribute to its growth and deliver exceptional services to the community. The leadership team at Mercy Southeast impressed me, and I’m eager to foster strong relationships within this team to establish our hospital as the premier health care provider serving southeast Missouri.”
Buckley recently relocated to Cape Girardeau from Hattiesburg, Mississippi, with his wife, Michelle, and their 10-year-old twins, Brooks and Mackenzie, while their oldest daughter, Madison, is beginning her freshman year at the University of Southern Mississippi. In his free time, he enjoys golfing.
Buckley earned a bachelor’s in nursing from Alcorn State University in Alcorn, Mississippi. During his previous leadership roles, his interest in hospital administration grew. He then earned a Master of Health Care Administration from The Franciscan Missionaries of Our Lady University in Baton Rouge, Louisiana.
Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized quality care and one of the nation’s largest Accountable Care Organizations. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and more than 47,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Te
Mercy Southeast is expanding patient access to primary care with more providers. Patients will soon be able to see Morgan Siemer, nurse practitioner, and Renae Koehler, physician assistant, for care at Mercy Primary Care – 817 S Mount Auburn in Cape Girardeau.
Morgan Siemer, a nurse practitioner, will move into her new role this month. Since 2020, she’s managed the congestive heart failure clinic at Mercy Clinic Heart and Vascular – Broadview.
“By moving to a primary care setting, I’m hoping to expand the resources and services I provide to patients and their families,” Siemer said. “I’m looking forward to treating the patient as a whole and managing multiple medical conditions. As a health care provider, the opportunity to further my career and knowledge base is exciting.”
A graduate of Southeast Missouri State University, Siemer earned her nursing degree and RN certification in Cape Girardeau. She then furthered her education with an APRN certification at Maryville University in St. Louis.
Siemer is a native of Cape Girardeau County and enjoys spending time with her husband, Ethan, their two children, Matthew and Maria, and two shih tzu dogs, Moose and Sturgill.
New to southeast Missouri and to Mercy is physician assistant Renae Koehler. Originally from Charlotte, Michigan, her interest in health care was sparked when she gave her grandfather insulin shots as a child.
“I’m most looking forward to creating lasting relationships with members of my community,” Koehler said. “I’ve always loved following and improving the outcomes of patient care from the beginning of my medical career, and I’m blessed that joining Dr. Danette Miller will allow me to not only treat but also know my patients, including their backstories and who they are.”
Koehler earned her associate degree in pre-medicine from Lansing Community College in Lansing, Michigan. She received her Bachelor of Exercise Science from Transylvania University in Lexington, Kentucky and a Master of Health Sciences in physician assistant studies from Lincoln Memorial University in Harrogate, Tennessee. She’s also earned a Doctor of Medical Sciences in general medicine.
Koehler enjoys crafting and making things by hand. Together with her husband, Aaron, a physician assistant at Mercy Convenient Care – Jackson, they enjoy back country hiking, playing and running with their dogs, working on the family farm and homesteading projects.
To make an appointment at Mercy Primary Care – 817 S Mount Auburn, call 573.519.4500. Hours are 7 a.m. to 7 p.m. Monday through Thursday and 8 a.m. to 4:30 p.m. Friday.
Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized quality care and one of the nation’s largest Accountable Care Organizations. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and more than 47,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas.
Mercy Southeast’s team of gastroenterology specialists is growing with the addition of Cody Kern, MD.
Dr. Kern began seeing patients at Mercy Clinic Gastroenterology – Broadway on August 12. The clinic, located at 1723 Broadway, Suite 315, Cape Girardeau, Missouri, works to prevent, diagnose and treat disorders of the digestive system.
“I’m looking forward to serving the community I’ve always considered my home,” Dr. Kern said. “I’m excited to join such a strong group of physicians and advanced practice providers, who are already providing great gastroenterology care to Southeast Missouri.”
Joining Mercy Southeast brings Dr. Kern full circle.
“My initial exposure to health care was actually as a volunteer at this hospital and shadowing while a teenager and in my early twenties,” he said. “Shadowing with my now partner, Dr. Brent Keller, is what first sparked my interest in gastroenterology.”
Dr. Kern will join Dr. Keller, Dr. Shane Hendon and nurse practitioners Andrew Garner and Kaitlin Roslen to provide a wide range of diagnostic and treatment services.
Dr. Kern earned an undergraduate degree in biology from William Woods University in Fulton, Missouri, and his medical degree from the University of Missouri – Columbia School of Medicine. He completed an internal medicine residency and his gastroenterology fellowship at the University of Kentucky in Lexington, where he’s lived the last six years.
A native of New Hamburg, Dr. Kern is excited to return to Southeast Missouri along with his wife, Claire, their two young children and their goldendoodle, Henry.
“It had always been our intention to return to the area,” he said. “Our friends and family are here. We cannot imagine a better place to raise our children. I am a member of the Knights of Columbus Council in Oran and St. Lawrence Church in New Hamburg. My wife and I hope to continue becoming more involved in our community now that we have returned home.”
Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized quality care and one of the nation’s largest Accountable Care Organizations. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and more than 47,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas.
Mercy Hospital Southeast Nationally Recognized for High-Quality Heart Failure Care
Mercy Hospital Southeast is being nationally recognized with the American Heart Association’s Get With The Guidelines® - Heart Failure Gold Plus quality achievement award for its commitment to improving outcomes for patients with heart failure, meaning reduced readmissions and more healthy days at home.
About 6 million U.S. adults are living with heart failure, a number that is expected to increase to more than 8 million by 2030. Despite the name, heart failure doesn’t mean the heart has stopped working – it means the heart is having a hard time pumping blood and oxygen throughout the body. While there’s no cure for heart failure, patients can live a quality life by working with their health care team to create and stick with a plan that may include medication, symptom monitoring and lifestyle changes.
“We’re very excited to receive this recognition,” said Regina Moore, Mercy Southeast quality management specialist. “This is our sixth year earning this award for the work we do to care for the heart failure patient population in Southeast Missouri. There are a lot of moving parts in this work, which include the heart failure team, led by Dr. Munis Raza, and our heart failure nurse practitioner, Morgan Siemer. For our hospital inpatients, education is provided by the nursing, cardiac rehab, transitional care, palliative care, pharmacy and nutrition teams.”
The Get With The Guidelines - Heart Failure quality achievement award is earned by hospitals that demonstrate a commitment to treating patients according to the most up-to-date guidelines as outlined by the American Heart Association. Get With The Guidelines puts the expertise of the American Heart Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest research- and evidence-based guidelines. The program aims to increase healthy days at home and reduce hospital readmissions for heart failure patients.
“Our specialists work hard to serve our patients at the outpatient level as well, and in return, we are able to decrease hospital admissions,” Moore said. “Serving our patients to the best of our ability is our mission.”
Mercy Hospital Southeast is also recognized on the American Heart Association’s Target: Heart FailureSMHonor Roll and Target: Type 2 Diabetes Honor Roll™. Hospitals on the heart failure honor roll meet specific criteria that improve medication adherence, provide early follow-up care and coordination and enhance patient education. The goal is to further reduce hospital readmissions and help patients improve their quality of life in managing this chronic condition.
The Target: Type 2 Diabetes honor is for facilities that aim to ensure patients with Type 2 diabetes, who might be at higher risk for complications, receive the most up-to-date, evidence-based care when hospitalized due to heart disease.
Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized quality care and one of the nation’s largest Accountable Care Organizations. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and more than 47,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas.
