In California, Dignity Health and Anthem Blue Cross have terminated their network agreement. This removes Dignity hospitals and medical clinics across California from Anthem’s network.
For the past six months, Dignity Health and Anthem Blue Cross have been in contract negotiations.
Despite their efforts, most of Dignity Health’s California agreements with Anthem were terminated on July 16,
Anthem Blue Cross members received a letter in the mail notifying them that Dignity Health doctors and hospitals will no longer be in their plan's network.
Others received the news over the phone from their doctor.
“I received a call less than 24 hours prior to my scheduled induction and I was notified by the doctor’s office that there was going to be a change of coverage as of midnight,” said Dignity Health patient Lorna Spears.
Spears is a patient at Bishop Peak Women’s Health Center and just delivered her third baby at French Hospital.
Spears said, “I was never really given a clear answer from either my provider’s office or from my insurance company saying whether or not my induction would be covered.”
Dignity Health explained it is a nonprofit health care system and California’s largest Medicaid provider.
A spokesperson said in recent years, the corporation has lost a lot of money, while Anthem is a for-profit insurance company receiving billions in profits.
Dignity Health described what it hopes for the new contract negotiations saying in part, "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 added it offered Anthem rates that do not "even cover inflation costs."
Anthem Blue Cross responded in a statement saying in part, "..We try to strike a balance between protecting affordability and providing a broad network of providers to create choices, which can take time...."
Both Dignity Health and Anthem Blue Cross say they’re providing transition assistance for those needing emergency medical services. But Spears said the process of getting coverage was stressful.
“I was on the phone pretty much all day with either my doctor’s office and my insurance company. At one point I had two phones and I had the insurance company and the doctor’s office talking to each other,” Spears said.
Dignity Health and Anthem Blue Cross are continuing to negotiate the terms of the new California agreement, but until then, patients may have to seek care elsewhere.
Anthem says, "As of July 15, 2021, Dignity facilities are no longer 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."