Adventist Health and Anthem Blue Cross mutually agreed to extend their contract to Aug. 1 in order to give both parties time to reach an agreement in ongoing contract negotiations.
The last-minute extension was made over the weekend, just before the contract between Adventist Health and the insurance company was set to expire on Monday. It gives thousands of Anthem Blue Cross insurance holders more time to access the only provider of hospital-based care in Mendocino County.
It is unclear if an agreement will be reached in the two-week extension, but Anthem Blue Cross holders will still be able to access healthcare as normal in that period of time in Mendocino County. If the two companies do not reach an agreement, Adventist will no longer be able to serve individuals insured by Anthem Blue Cross. If individuals are in the hospital on Aug. 1 — when the contract would expire if an agreement was not reached — they will be covered by Anthem until they are discharged, according to an Adventist FAQ regarding its contract negotiations. Members currently receiving ongoing care may be eligible for continuity of care coverage and should contact Anthem customer service.
Anthem may transfer patients to other hospital systems that support its insurance, but only if the transfer is safe to perform, according to Adventist.
In its contract negotiations, Adventist has asked Anthem to pay the hospital network a higher reimbursement rate to make up for the highest inflation in 40 years and costs the hospitals have incurred during the ongoing coronavirus pandemic. The insurance company has increased premiums for policyholders but hasn’t increased reimbursement rates for Adventist hospitals and clinics, Adventist Health President of Mendocino County Judson Howe said in an interview with the Voice.
“Adventist Health for the last ten years has accommodated whatever Blue Cross has for from a rate perspective, and here we are 2022, ten years in, we haven’t really pushed hard at all. So as a result Adventist Health is about 20% off what Blue Cross is paying hospitals just 30 miles down the road,” Howe claimed. “Employees and community members in Mendocino are paying premiums to a company that then is not investing that back into the local community.”
Spokespeople for both Adventist and Anthem declined to provide the current reimbursement rates and what Adventist proposed during negotiations.
“Anthem Blue Cross has agreed to an extension with Adventist Health so we may continue negotiating in good faith in an attempt to retain the health system in our care provider network,” according to an Anthem Blue Cross statement issued Monday. “We believe our care providers should be reimbursed fairly, and that will continue to be reflected in our offers during these negotiations.”
“These offers included reasonable increases that are in line with what other provider partners receive for the same services, which will help keep healthcare affordable for those we serve. Our hope is to reach an agreement with Adventist,” the statement continued.
The contract between Adventist Health Ukiah Valley and Anthem Blue Cross is separate from the other Adventist hospitals in Mendocino County and will expire Sept. 18, Mike Bowman, director of public relations for Anthem in California, told the Voice. The hospital will remain in-network through that date if a contract is not renewed.
Part of the negotiations between Anthem and Adventist are to bring the Ukiah Valley facility into the larger contract with other Adventist Health hospitals.
If you are unsure about your insurance coverage, call the number listed on your insurance card. Information about filing complaints with the state Department of Insurance can be found here.