Editor’s note: People with Anthem health insurance who see doctors at Dignity Health and Dominican Hospital are caught in the middle as talks on a new contract broke down mid-July. How are you affected? Email Editor Jondi Gumz at [email protected] Put Anthem-Dignity in the subject line. Each side put out statements, appearing here in abbreviated fashion.
Robert Quinn, MD, president/CEO, Dignity Health Medical Foundation
Dignity Health and Anthem Blue Cross have been negotiating new contracts in good faith for six months. Despite our collective efforts, most of Dignity Health’s California agreements with Anthem terminated as of July 16.
“… Dignity Health is a nonprofit health care system and California’s largest Medi-Cal provider and has lost money in recent years, while Anthem is a for-profit insurance company that earns billions of dollars in profits.
“New contracts with Anthem will let our doctors and nurses continue confronting the COVID-19 pandemic and providing essential services to our patients. Dignity Health has offered Anthem a proposal with rates that do not even cover hospital inflation costs and are below increases included in prior agreements.”
Dignity Health will continue to treat all patients in need of emergency care through our hospitals’ Emergency Departments, regardless of the hospital or physician’s network status.
Dignity Health is a nonprofit network of 10,000 physicians, 60,000+ employees, 41 acute care hospitals, and 400+ care centers in Arizona, California, and Nevada.
Anthem Blue Cross July Press Release
For many years, Anthem members have been able to receive in-network care from Dignity Health, which unfortunately has become one of the more expensive health systems in California.
Dignity issued contract termination notices to Anthem for the vast majority of its Anthem business and has now informed us if we do not agree to substantial rate increases it will leave our health plans, making care at Dignity hospitals, medical groups and clinics unavailable to Anthem members.
Anthem’s intent is to reach agreement on reasonable contractual language and reimbursement rates that will help protect affordability for consumers. We cannot, and will not, agree to excessive rate increases that will make care at Dignity even less affordable for those we serve.
Dignity rates are … almost 30 percent more expensive than other health systems. Dignity charges commercial insurance members in excess of 300 percent of the Medicare allowable rate for some services. If we were to give in to Dignity’s demands for excessive rate increases, it would result in higher out-of-pocket and premium costs for our members. That’s something we just can’t do.
If we do not reach a new agreement by July 15, Dignity facilities will no longer be in our health plans for members enrolled in Commercial PPO, EPO, HMO, and POS benefit plans as well as some Medicaid and Medicare Advantage plans. This includes Dominican Santa Cruz Hospital.
Editor’s Note: Sutter Maternity & Surgery Center in Santa Cruz is in Anthem’s network but it doesn’t have an emergency room or urgent care. Also in Anthem’s network is Watsonville Community Hospital, which does have an emergency department.
Anthem, Sutter Health Extend Contract
Anthem and Sutter Health have reached agreement on a multi-year extension to their previous contract, set to expire in 18 months. This provides Anthem members with continued in-network access to Sutter facilities through Dec. 31, 2024.
“We are pleased to continue working with Sutter to make healthcare simpler and more accessible,” said John Pickett, Anthem’s regional vice president of provider solutions. “We value the relationships we have with the providers in our network, which are important to creating choices for our consumers and fulfilling our mission of improving the lives of the people in the communities we serve.”
“We are pleased to partner with Anthem in their expanded portfolio of networks and products as it will give our Sutter patients stability and access to our integrated network for years to come,” said Grace Davis, Sutter’s chief public affairs officer.
This agreement applies to Anthem Blue Cross consumers enrolled in Medi-Cal, HMO and PPO plans.