Northern Light Health said Wednesday that negotiations have stalled on a new contract with Anthem Blue Cross Blue Shield, raising the possibility that its hospitals and health care providers may no longer be in-network for many patients starting Sept. 30.

If they do not reach an agreement before the contract expires, Anthem health insurance plans would be considered out-of-network for Northern Light health care providers, which includes Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland, and a large network of primary care and specialty care services. Out-of-network services typically cost more for patients, depending on the type of insurance that is purchased.

The outcome could affect thousands of patients statewide. Northern Light is Maine’s second largest health care network, while Anthem is Maine’s largest private insurance carrier.

About 370,000 people in Maine have Anthem insurance. It wasn’t clear Wednesday how many of those subscribers receive care from Northern Light providers.

Northern Light blamed the stalled talks on Anthem reimbursement rates that don’t cover the cost of its health care.

“For years, Anthem has cited rising costs of care to justify increasing the premiums paid by their customers, while our reimbursements from Anthem have seen an average annual increase of less than 1.5%,” James Rohrbaugh, Northern Light’s executive vice president and chief financial officer, said in a written statement. “The annual inflation rate for health services has averaged more than 7.5%. Anthem’s unwillingness to keep pace with the costs of providing care directly contribute to the risks facing rural health care.”

Northern Light’s statement announcing the stalled talks said Anthem has a responsibility to help sustain rural health care.

“As the largest commercial insurer in Maine, Anthem plays a critical role in the sustainability of health services in the state. While Anthem payment denials for care already provided to patients have measurably increased, Anthem increased its profit margin in Maine by nearly 10% in 2024,” it said.

“Northern Light Health has informed Anthem that unless they agree to a contract with adequate reimbursement, their contract will expire on September 30, 2025. …  For the next four months, Northern Light Health will focus on helping patients and group policy holders understand their options to access the services they need if the contract expires.”

Northern Light patients who carry Anthem insurance would either be forced to pay higher fees, or switch to other providers or insurance carriers to avoid the higher costs.

Anthem said the Northern Light Health’s statement about the Sept. 30 cutoff is misleading.

“Anthem Blue Cross and Blue Shield and Northern Light Health are currently in discussions to continue member access to affordable care at Northern Light’s doctor’s offices and hospitals beyond December 30, 2025,” Anthem said in its statement. “Unfortunately, Northern Light’s statements referencing September 30 are misleading. Our current contract runs through that date, however it includes a minimum 90-day extension to allow both parties continued negotiation time to avoid member care disruption.”

Anthem said “the core discussion point is health care affordability.”

“Despite their current payment rates being in line with other health systems in Maine and higher than many, Northern Light seeks to raise the prices it charges to patients covered by Anthem by 30% over the next three years,” Anthem’s statement said. “These price hikes would increase health care costs by $218 million for patients and northeast Maine employers.”

Northern Light has faced financial struggles during the past few years, resulting in curtailed services and the closing of Northern Light Inland Hospital in Waterville.

High-stakes negotiations between health care networks and insurance carriers are not unusual.

MaineHealth, which is the state’s largest health system and operates Maine Medical Center in Portland, had a high-profile dispute with Anthem over their contract in 2022, but they settled before there would have been any disruption in services.

That dispute went public when MaineHealth announced Maine Medical Center planned to leave the Anthem insurance network because of the insurer’s payment practices, including what hospital officials say was $13 million in underpayments to the hospital and more than $70 million in unpaid claims to the MaineHealth network.

Anthem responded by saying MaineHealth routinely overcharged for medications. Both sides provided examples, such as Maine Med charging $136 for a $2 bag of saline solution and Anthem only agreeing to pay for one of two heart stent procedures performed on the same patient in the same day.

That dispute potentially affected more than 150,000 patients and had the potential of affecting the entire market in Maine, depending on how many patients changed providers or change insurance carriers to avoid the out-of-network fees.