Dignity Health Seeks to End Relationship with Anthem Blue Cross
July 22nd, 2021
Anthem will ensure continuity of care for members
July, 2021
For many years, Anthem Blue Cross (Anthem) members have been able to receive in-network care from Dignity Health (Dignity), 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 that 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.
Anthem is taking steps to help our members make seamless transitions to new care providers and facilities, and we are launching a continuity of care plan for people with special health circumstances, in case we are unable to reach an agreement with Dignity by July 15, 2021.
Why is this happening?
Contractual relationships involve periodic negotiations, and for the past several months Anthem and Dignity have been in the process of negotiating a new contract to Dignity and its physicians in our members’ health plans.
Dignity rates are some of the highest among all health systems in California, making it almost 30 percent more expensive than other health systems in the state. For example, 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.
How Anthem is ensuring a seamless transition of care for our members
Impacted Members
If we are unable to reach a new contract agreement by July 15, 2021, 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.
Impacted Facilities
This also means the following Dignity facilities would no longer be in our health plans as of July 15, 2021:
- Bakersfield Memorial Hospital
- California Hospital Medical Center
- Community Hospital of San Bernardino
- Dominican Santa Cruz Hospital
- French Hospital Medical Center
- Glendale Memorial Hospital
- Marian Medical Center
- Marian Regional MC Arroyo Grande
- Mark Twain St. Joseph’s Hospital
- Mercy Healthcare Bakersfield
- Mercy General Hospital
- Mercy Hospital of Folsom
- Mercy Medical Center – Merced
- Mercy Medical Center – Mt Shasta
- Mercy Medical Center – Redding
- Mercy San Juan Hospital
- Methodist Hospital of Sacramento
- Northridge Hospital Medical Center
- Sequoia Health Services
- Sierra Nevada Memorial Miners Hospital
- St. Bernardine Medical Center
- St. John’s Regional Medical Center
- St. John’s Pleasant Valley Hospital
- St. Elizabeth Community Hospital
- St. Joseph’s Medical Center of Stockton
- St. Mary Medical Center Long Beach
- St. Mary’s Medical Center
- St. Francis Memorial Hospital
- Woodland Memorial Hospital
Alternate Facilities
Members who need help locating an in-network hospital can call the toll-free member number listed on their Anthem member ID card or they can use the Find a Doctor function at anthem.com/ca/find-care.
Emergency Medical Care
Emergency medical services are always considered a covered benefit and therefore do not require pre-authorization, regardless of where they are delivered. Anthem encourages consumers to make informed decisions about when to use urgent care as opposed to emergency room care. Urgent care is usually appropriate when you need a physician’s attention for a condition that is non-life threatening and your primary care physician is unavailable.
Continuity of Care
Transition assistance to ensure in-network continuity of care would be available for Anthem members who are pregnant, undergoing a course of treatment, or who have obtained a prior authorization for services. Members can call the member services number on their Anthem member ID card to find out if they are eligible for continuity of care. Emergency medical services are always considered a covered benefit and therefore do not require pre-authorization, regardless of where they are delivered.
Staying Informed
For the most up-to-date information refer to this site or members can call the member services number on their Anthem member ID card. This site will be updated as new information becomes available.
Original source: anthem.com/ca/dignity/