Interview with Dr. Cory Donovan

Surgical Oncologist 

As a provider and health care advocate in this community, what are your concerns about the ongoing negotiations between Legacy Health and Cigna?  

As a provider, I am primarily concerned by how this is going to impact my patients. Many of my patients have breast cancer.  It is distressing that in the middle of a cancer journey, they would also have to worry about when, how and if they will get the care they need. It feels fundamentally unfair that they are having to face this additional uncertainty when they are facing one of the scariest things in their lives. There shouldn’t be additional paperwork, more hoops they need to jump through to get the care they need. They have done enough. They are doing enough.  

I’m concerned about the added anxiety. Imagine being diagnosed with precancer, scheduled for surgery and suddenly not knowing how or when it’s going to be taken care of. Imagine having cancer and getting a letter saying that you need to find a new provider and healthcare system. Why is it that patients are going to have to own this burden when they are already dealing with so much else? Some days it is hard enough to get up out of bed, put on your shoes and brush your hair when you have cancer. 

If an agreement is not reached, how will this affect Legacy patients who are Cigna members? How will it impact you as a provider? 

We have been here before, going to the brink with an insurance company to ensure that Legacy can break even with the cost of care. I am hopeful that an agreement will be reached, and we can continue to provide the excellent care that our patients, and Cigna, know we will provide.  

But this time feels different to me because we, as providers, cannot directly help patients appeal for continuity of care. And an appeal must be written by the patient for each different provider and episode of care. This feels like it is putting an impossible burden on the patients to fix a systemic problem. I feel that the patients are the ones that end up suffering the most from this uncertainty.  

But our teams also suffer. We’re going to be spending a lot of time not on direct patient care but on coordinating and ensuring patients get the care they need. We at Legacy will not leave them alone to figure this out by themselves. We’ll stand with them. Do not underestimate the amount of anxiety it’s going to cause patients and our teams. It’s profoundly disruptive to them. I worry that it will fracture the trust within the medical system. We already struggle with so much distrust. The patient, provider relationships are already fragile.  

What are you telling patients who have questions about this situation? 

I’m telling them that we are going to continue to help them through this journey. Again, I’m very hopeful that Legacy and Cigna can figure this out. We are all motivated by giving the best care that we can. We’re going to focus on that and make that happen for our patients.  

How are contract disputes like this impacting health care throughout this country? 

I feel like it’s significant that what we are experiencing is repeated at health systems and insurance companies across the country.  Again and again. It means a huge number of resources are being spent on nonpatient care and that hurts all of us. Imagine this level of disruption on a national level. And again, this is not the first time we have been through this in the last few years.  

I worry about smaller, not-for-profit systems that don’t have the same kind of negotiating power that for-profit corporate entities do. Are insurance companies offering us no change in reimbursement in the face of the rising cost of care because we don’t have same economic power on a national scale? Are we forced to go to the brink every time because they are using us to make an example for other small healthcare companies?  

If you could tell the head of Cigna one thing, what would it be? 

Please don’t use my patients as pawns in your negotiations. But I would also like to add, that if this takes more time to sort out, please figure out a way to take the burden off the patients so that they can continue to get the care they need and deserve.  Please stay at the negotiating table and figure this out for the health of patients in the Portland and Vancouver area. Our patients need Legacy to provide the exceptional care we can and do deliver every day. 

What would you ask of Cigna as the date of termination draws closer?  

I understand the economics have changed and I understand how uncertain healthcare delivery feels. I know that this is hard and what we’re asking is hard. But I also need them to recognize that their actions have a profound impact on the lives of many people facing life threatening and scary conditions. Let’s quickly negotiate a reasonable solution. Please allow us to focus on delivering care to our patients.

Do you share our provider’s concerns about Cigna members losing access to the care they need if an agreement isn’t reached with Legacy Health?

To ensure you, your family and other Cigna members continue to have access to their trusted health partners, we urge Cigna to agree to a fair and reasonable increase in our reimbursement that matches the actual cost of care.

We need your help to achieve this. Here’s how:

• Contact Cigna using the phone number on the back of your member ID card and ask them to support Legacy’s request for a fair and reasonable payment increase.
• Tell Cigna how important Legacy is to you and your family and urge them to reach an agreement before June 30, 2025.
• Share your feedback and concerns with your employer. Employers often influence health plan choices.
• Visit LegacyHealth.org/CignaContract for the latest information and frequently asked questions.