Inova, Cigna Reach Deal to Serve Exchange Customers

After three months of negotiations, Inova Health System has inked a new agreement that expands health care provider options for Northern Virginia residents who rely on offerings available through commonwealth’s health plan exchange.

Starting yesterday, Inova Health System has been added an in-network provider for Cigna’s Healthcare Exchange product, Cigna Connect. The change allows approximately 45,000 area residents to begin—or resume—using Inova services in Loudoun, Fairfax, Prince William and Stafford counties.

Area residents using Virginia’s exchange to secure their health care coverage learned late last year that Aetna, Innovation Health and United Healthcare where pulling out for 2018. Loudoun residents were left with two options on the exchange: Kaiser Permanente and Cigna Connect, which did not include Inova in their networks.

The exclusion of the region’s largest health care network from plans available to area residents was a surprise, but representative of the uncertainty over the structure and sustainability of the exchange system that grew from the federal Affordable Care Act. At times, exchange users in as many as 63 of Virginia’s 95 counties had no insurance coverage offerings. This year, 400,015 Virginians get their coverage through the exchange.

As the situation emerged last year, Inova President and COO Mark Stauder held out hope that a deal could be worked out to expand coverage. Inova had contracts with Cigna on other managed care plans, but was not in the network for the Cigna Connect exchange product.

On Friday, Stauder said that three months of negotiations, bolstered by pressure from exchange customers, paid off in recent weeks.

Stauder said Cigna was professional, responsive and good to work with. “We both worked hard to benefit the region,” he said.

“This will ensure we can continue to provide Cigna Connect’s customers with the exceptional patient experience they expect at Inova,” Stauder said in formally announcing the deal. “We are very pleased that our patients with Cigna Connect insurance will again have access to Inova hospitals, ambulatory services, physicians, clinicians, outpatient services and specialty care practices.”

The outlook for 2019 remains uncertain, but may not be as turbulent as this year.

“This was a very unusual situation,” Stauder said. Late last year, many carriers were working until the deadline to decide where they would offer exchange services and it was at the last minute that some of the biggest players, including United and Aetna, pulled out from the exchange. Anthem eventually reversed its plan to drop from the exchange and offered critical coverage for counties with no other options.  “It wasn’t clear who was going to serve the population,” Stauder said.

For 2019, the exchange situation will come into focus by late September when the plans are finalized.

Stauder said the exchange continues to be a popular option, especially for individuals and employees of small businesses.

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