Keystone First and Temple Health Reach Two-Year Agreement

Days before their contract was set to expire on July 31, 2024, Keystone First and Temple Health System reached a new two-year agreement, thereby ensuring participants’ uninterrupted access to Temple Health’s services, including providers and hospitals. With this agreement, Temple Health hospitals and physicians will remain in-network for Keystone First plans, including Keystone First HealthChoices (Medicaid), Keystone First Community Health Choices (CHC), and Keystone VIP Choice Medicare Advantage.

Keystone First is the largest Medicaid Managed Care Organization in Southeastern Pennsylvania, serving 55% of Medicaid recipients in the region. According to an American Hospital Association study, 45% of Temple University Hospital's patient population are Medicaid recipients. Temple Health reported a $23.3 million loss for the nine months ending in March 2024 and has indicated a need for higher reimbursement rates to manage rising costs.

After months of unsuccessful negotiations, Temple Health warned patients about the potential loss of in-network status and suggested they consider enrolling in a different managed care organization to ensure continued care. Keystone First informed its participants that services at Temple Health would not be covered beyond July 31st. However, just days before the contract expired, Temple Health and Keystone First announced that they had reached an agreement. The new contract includes provisions for increased insurance reimbursements to Temple Health.