Augusta Health Announces Potential Change for Patients with Cigna Insurance Coverage

FISHERSVILLE, VIRGINIA— Augusta Health’s current agreement with Cigna is set to expire on December 31, 2025, as the negotiating parties have been unable to reach an agreement on a new contract. After months of active negotiations, the Augusta Health Board of Directors concluded that the reimbursement rate proposed by Cigna fell short of addressing the escalating healthcare costs experienced by Augusta Health and other health systems. Fair contracts with insurers such as Cigna are crucial for delivering comprehensive care to the Shenandoah Valley.

The negotiations with Cigna cover facility and physician services provided at Augusta Health care settings, except for Behavioral Health, which negotiate rates with Cigna separately.  Augusta Health is among the lowest paid in the local market by Cigna, and costs have increased 52% over the last five years, with no contracted rate increase from Cigna. Augusta Health continues to work diligently to preserve in-network status for Cigna beneficiaries.  

With ongoing healthcare funding pressures, it is more important than ever to ensure health systems receive fair compensation for the services they provide. “Financial sustainability of rural and semi-rural hospitals is threatened by the trend of lower reimbursement, which is not keeping pace with inflation,” said Mary N. Mannix, President and CEO of Augusta Health. “We seek fair reimbursement rates consistent with regional providers—nothing more, nothing less. We must fix our contract with Cigna to secure our future and continue being a trusted source for care. We encourage impacted individuals to review their options for continuity of care or transition coverage before it expires to avoid any lapse in care or services.”

As a model of community-based independent healthcare, Augusta Health is aware of the difficulties this situation may create for families and will persist in working with Cigna to secure a fair resolution. Concerned Cigna members are encouraged to contact Cigna Member Services at the number on their ID cards to express their opinion that Cigna should engage in meaningful discussions to keep Augusta Health in-network.

If the parties do not reach an agreement, patients with Cigna insurance coverage receiving care from Augusta Health may experience higher out-of-pocket expenses. Still, patients can get care from Augusta Health facilities and physicians, and emergency care won’t be affected.

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