Jefferson Health announced over the weekend that it did not finalize a new contract with Cigna, a multinational healthcare and insurance company.

Effective immediately, Jefferson Health will be considered out of network for Cigna commercial members, the health care system said in a statement.

“We understand that this news may cause concern, and we want to reassure our patients that we remain committed to providing high-quality care,” Jefferson Health said. “We continue to negotiate in good faith with Cigna to reach a resolution that is fair and sustainable for our patients, providers, and community.”

The Philadelphia Inquirer noted that the issue mainly concerns those with health insurance through their employers. Cigna’s Medicare Advantage plans, such as Bravo and HealthSpring, remain in-network at Jefferson.

Cigna said in a statement Monday that Jefferson was asking for “unreasonable” increases. “Almost all our employer clients’ benefits plans are self-funded, which means any increase in cost of care is paid directly by local employers, their employees and their families,” Cigna said.

Cigna has 38,000 people in Medicare Advantage plans in the Philadelphia area, and people in those plans who rely on Jefferson doctors are not affected by Saturday’s announcement, The Inquirer said.

According to Jefferson Health’s statement, the reason for the nixed contract is because “our current contract does not reflect the true cost of delivering high-quality care.”

It goes on to explain:

• Since 2020, Cigna’s reimbursement rates have increased by only ~3%, while the Hospital Wage Index has risen 20% and CPI-U has increased 21%
• Rising costs for labor, medical supplies, and operations make it unsustainable to continue at these below-market rates.
• Other insurers in our communities have recognized these economic realities, and Jefferson has successfully reached agreements with them.

Patient Access and Next Steps

• Emergency care remains in-network for all Cigna members, regardless of contract status.
• Some patients may qualify for Transition of Care programs to maintain in-network benefits—please check with Cigna.
• Many Cigna plans include out-of-network benefits that may allow continued access to Jefferson providers.

Cigna members are encouraged to contact Cigna directly “to understand their coverage options and advocate for continued access to Jefferson Health providers,” the statement said. “Our priority remains delivering the highest quality care while securing fair agreements that support our mission. We appreciate your patience and support as we work toward a resolution.”

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