Jefferson Health said that its Philadelphia and Lehigh Valley facilities may stop accepting Highmark insurance on January 1 without higher payments, The Philadelphia Inquirer reported.

In September, the nonprofit said Independence Blue Cross will no longer be accepted in 2027 without higher rates, noting that the nationwide insurer pays Jefferson Health 40% less than the national average.

“We are negotiating in good faith with Highmark on behalf of our clinicians and patients to ensure that more of the premium dollars Highmark collects are going toward patient care. Equally troubling are Highmark’s arbitrary policy changes that violate their own contracts and compromise patient care,” Jefferson told The Inquirer in an email.

On September 24, Independence Blue Cross published a press release with FAQs regarding their negotiations with Jefferson Health.

An excerpt:

The comparisons Jefferson Health is sharing publicly are misleading and obscure the facts. They rely on hospitals in markets such as New York and California and on averages that are not representative of the Philadelphia region. Those comparisons do not reflect the reimbursement rates that matter to members and customers here at home and instead create a distorted picture that supports Jefferson’s unprecedented rate demands.

Other health systems in our region receive reimbursement rates comparable to what we currently pay Jefferson Health and remain financially stable, with several posting profits. We do not believe our members and customers should be asked to pay more for the same care from Jefferson as they receive from other physicians and hospitals in the region.

Jefferson Health published the statement below:

Estimates of how many patients would be impacted if Jefferson stops taking Highmark insurance next year were not immediately available, The Inquirer said.

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