The Mayo Clinic, along with other prominent health care institutions pulled out of a $2.8 billion settlement reached to resolve an antitrust lawsuit that the providers brought against insurance behemoth Blue Cross. Mayo, along with other health care leaders like Mass General Brigham, Children’s of Philadelphia and the University of Michigan Hospital rejected the settlement that would provide reforms to the doctor/patient/payer experience as well as provide financial compensation.
The settlement was reached in October, 2024 after a years-long battle between the health care providers and Blue Cross. The provider’s lawsuit claims that the insurers unfairly carved up patient turf to create an anti-competitive market. Providers first sued Blue Cross Blue Shield Association (BCBSA) and 33 affiliates in 2012 contending that they insurers colluded with each other to avoid competition and lower reimbursement.
The Blues agreed to significant reforms to improve patient services as well as the $2.8 billion payment to providers. The settlement included significant improvements to its BlueCard program, that connects patients and insurers for prior authorization requests, claims tracking and payment processing.
The Mayo opt-out will allow future litigation and negotiation to resolve the dispute. Mayo hopes to improve reimbursement rates, as well as insurance related communication for patients and doctors.
