Insurance issues: Blue Cross customers in Nevada County, across state lose coverage at Dignity Health hospitals
Sierra Nevada Memorial Hospital patients who are covered through Anthem Blue Cross will no longer receive benefits, after the hospital’s parent health care company terminated its contract with Blue Cross earlier this month.
Dignity Health, which owns or operates around 40 hospitals throughout California, including the Grass Valley hospital, announced in an email statement that its contract with Blue Cross was officially terminated on July 16. The two health care giants had been struggling to reach an agreement to renew their previous contract, according to a statement last month by Blue Cross.
“Unfortunately, Anthem has been unwilling to agree to a new contract that would allow us to maintain the services our patients and communities depend on,” Dignity Health said in a release regarding the contract dispute.
Almost all of Dignity Health’s California hospitals will no longer be in network with Blue Cross. A select few hospitals will remain in network with Blue Cross for the time being, with those facilities specified on Dignity Health’s website.
Sierra Nevada Memorial Hospital is one of the hospitals affected by the contract termination. New patients who are admitted to the Grass Valley hospital after July 16 will no longer be able to apply their Blue Cross insurance plans to cover health care costs, according to spokesperson Chad Burns.
Individuals who had already been receiving care from Dignity Health prior to the July 16 contract termination will still be able to apply their Blue Cross benefits to cover costs, Burns added.
Patient Provider Organization (PPO) plans, Health Maintenance Organization (HMO) Plans, and Healthcare Management Administrators (HMA) plans, along with virtually all other health care packages will no longer be accessible to Blue Cross customers at Dignity Health facilities.
Blue Cross acknowledged that out-of-pocket costs are likely to go up for its customers in areas affected by the contract termination, in an announcement released last month while contract negotiations between the two entities were still ongoing.
“This hospital contract termination could affect the out-of-pocket obligations for most Anthem Blue Cross members who are enrolled in Commercial PPO, EPO, HMO, and POS benefit plans and receive care at Dignity Health,” Blue Cross said.
Blue Cross also released a statement to customers on July 1 in which it said that the contract negotiations were failing because Dignity Health had insisted on substantial rate increases in customers’ health plans, if a contract was to be renewed.
“Dignity … 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 … we cannot, and will not, agree to excessive rate increases that will make care at Dignity even less affordable for those we serve,” Blue Cross said in the release.
Conversely, Dignity Health placed the blame for the failure of a contract renewal squarely on Blue Cross, asserting that the insurance company made demands during the negotiations that would have “threatened” Dignity Health’s ability to provide quality care for patients.
“Make no mistake, Anthem’s proposal would threaten Dignity Health’s ability to keep Emergency Departments open, provide advanced clinical care and retain our employees in California and Nevada,” the statement read.
Dignity Health did not comment on what Anthem’s proposal was that it claimed derailed the negotiations, and neither health care organization responded to a request for comment on the specific issues discussed in contract negotiations.
Around 8.3 million California residents are covered through Blue Cross, according to Covered California, an insurance agency based in Santa Rosa.
Stephen Wyer is a staff writer with The Union. He can be reached at firstname.lastname@example.org
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. We remain in active discussions and hope to reach a responsible new agreement soon that will protect patients’ access to the care they need. We know how important it is for patients to have access to the providers and services they trust. We are doing all we can to avoid disruption for our patients and communities. If we are not able to reach a new agreement soon, we will provide additional information for our patients.
Individuals who are currently receiving or have plans to receive care may be able to continue receiving care from Dignity Health using their in-network benefits. Dignity Health has made efforts to reach out to our Anthem patients that are involved in a course of treatment or have procedures scheduled to assist them with completing Continuity of Care documentation so that care is not impacted. For more information, patients and providers can visit http://www.keepdignityhealth.org or reach out to Dignity Health at 1-800-483-1568, or contact Anthem using the number on the back of their member benefits card.
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.
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