The Doctor Will See You Now: Anthem Blue Cross, Adventist Health Finally Reach Contract Agreement
- New contract between Adventist Health and Anthem Blue Cross is effective immediately, meaning patients will not lose coverage.
- The agreement follows months of back-and-forth and two negotiation extensions.
- Adventist Health had said it needed Anthem Blue Cross to pay higher reimbursement rates in order to cover expenses.
16 August 2022 | The Adventist Health healthcare system and insurance company Anthem Blue Cross reached a contract agreement on Aug. 11, 2022, effective immediately, that provides Anthem health plan members with continued in-network access to hospital-based services at Adventist Health facilities, according to an Adventist Health statement.
“We are pleased to continue our long working relationship with Anthem Blue Cross,” said Todd Hofheins, chief operating officer, Adventist Health. “Our mission calls us to provide high quality care to patients in our communities and we’re excited to continue caring for Anthem Blue Cross members.”
If no agreement had been reached, patients would have lost coverage at one of the major hospital systems in central California, U.S., reported the San Joaquin Valley Sun newspaper.
Adventist Health operates hospitals in Bakersfield, Delano, Hanford, Reedley, Selma, and Tulare. Of the latter four cities, Adventist Health is the sole hospital in the area.
Without an agreement, Central Valley residents in California covered by Anthem wouldn’t have been able to afford visits to Adventist medical centers in Hanford, Reedley, Selma, and Tulare, reported the Sun-Gazette. Adventist Health’s Central Valley network of medical facilities sees more than 1 million patients per year.
The agreement follows months of back-and-forth and two negotiation extensions. In the last five months, Adventist Health and Anthem had exchanged 14 contract proposals, according to news station ABC 23. Their contract had originally been set to expire on July 18, 2022, but both sides agreed to a two-week extension to continue negotiations. On Aug. 1, they agreed to extend the negotiations again to Aug. 16, 2022.
Adventist Health said it needed Anthem Blue Cross to pay higher reimbursement rates in order to cover expenses “that continue to exceed the reimbursement we receive,” in another statement on the Adventist Health website.
“Anthem Blue Cross has continued for the past two years to enjoy record profits, even in this highly inflationary environment. While Anthem raised members’ premiums annually, they continue to pay Adventist Health substantially less than the other hospital systems,” the previous Adventist Health statement said.
Anthem Blue Cross countered that its reimbursement rates had been accepted by other local hospitals, and that its increases were in line with what other provider partners had received for the same services.
Although no details about the contract’s reimbursement rates were released, John Pickett, regional vice president for Anthem Blue Cross, said the organization was pleased by the mutual agreement it had reached with Adventist Health. “The successful resolution of our discussions builds on our long-term partnership and shared commitment to providing access to high-quality care for those in the communities we serve,” said Pickett.
(Photo: The Adventist Health healthcare system and insurance company Anthem Blue Cross reached a contract agreement on Aug. 11, 2022, effective immediately, that provides Anthem health plan members with continued in-network access to hospital-based services at Adventist Health facilities. Photo via Adventist Health website.)
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