Northern Light Health reaches deal with Maine insurer to lower costs


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Key Partnership: Lowering Healthcare Costs in Maine

Northern Light Health and Community Health Options (CHO), a Maine-based non-profit insurer, have forged a new agreement aimed at reducing healthcare costs and improving access to care for CHO members. The deal, effective immediately, simplifies access to Northern Light's nine hospitals and over 127 locations across Maine.

Immediate and Future Benefits

Immediate benefits for CHO members include improved rates and reduced need for prior approvals for hospital stays. Starting January 1, 2026, members will also see improved copayments and coinsurance rates at all Northern Light facilities. This collaboration is seen as a significant win for improving healthcare affordability and access.

Background: Recent Disputes and Context

This agreement comes in the wake of Northern Light Health's termination of contract negotiations with Anthem Blue Cross and Blue Shield, highlighting ongoing challenges in the Maine healthcare market. Previous disputes, such as the 2022 MaineHealth and Anthem contract dispute, underscore the complexities and financial pressures within the industry. The partnership with CHO represents a proactive approach to addressing these issues and ensuring affordable care for Maine residents.

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Northern Light Health has reached a deal with a Maine-based insurer to lower costs for policyholders.

Community Health Options, a nonprofit, member-led insurer, said Wednesday that the deal lowers fees and simplifies access to care for members at Northern Light’s nine hospitals and more than 127 locations across Maine.

“We are thrilled to collaborate with a like-minded, willing nonprofit like Northern Light Health that shares our mission to help meet the challenges of escalating health care costs,” said Joanne Lauterbach, chief financial officer at Community Health Options. “This new agreement will help us to do even more to improve access to high-quality care at a lower total cost, ultimately improving the health and well-being of our Members.”

Under the deal, Community Health Options’ members will see improved rates and less need for prior approvals effective immediately. That means a member who is admitted to a Northern Light facility will have their entire hospital stay approved.

Then, starting Jan.1, 2026, members will see improved copayments and coinsurance rates at all Northern Light Health facilities.

“This new agreement is a huge win for Community Health Options’ Members across our state, creating a more efficient and cost-effective way to receive — and deliver — the care they need. It’s always inspiring to work alongside an organization that understands the needs of patients here in Maine — our neighbors and community members — and together, share a commitment to both sustainability and access to health care services in our rural communities,” said James Rohrbaugh, executive vice president and chief financial officer for Northern Light Health.

That comes after Northern Light Health health broke off contract negotiations with Anthem Blue Cross and Blue Shield last week, meaning the system’s hospitals, primary care and other services will move outside the insurer’s network on Oct. 1.

In severing negotiations, Northern Light said it sent Anthem a counteroffer on July 30, but the insurer declined to submit a response. The system hopes an agreement can be reached.

In 2022, a contract dispute between MaineHealth and Anthem played out in public, with the health system accusing the insurer of owing millions in back payments and holding up and disputing millions more in payments, while Anthem accused MaineHealth of millions in overcharges.

Before the contract expired, both sides reached a deal, preventing MaineHealth from withdrawing from Anthem’s network.

Earlier this week, Anthem announced a partnership with ConvenientMD to include its Bangor primary care office on Broadway within the insurer’s network.

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