Edward Martin, site administrator at Adventist Health Tehachapi Valley hospital, addressed members of the board of directors of Tehachapi Valley Healthcare District at their regular meeting on July 19 concerning the health system’s contract with Anthem Blue Cross.
Daniel Wolcott, president of Adventist Health for Kern County, shared information about negotiations between the Adventist Health system and insurer Anthem at a news conference in Bakersfield July 13. At the time, the contract was set to expire on July 18. But Martin said he received a call from Wolcott on July 17 letting him know the contract had been extended to allow negotiations to continue.
Megan Simpson, spokesperson for Adventist Health, confirmed Friday that the two entities mutually agreed to a two-week extension of their contract, which was due to expire on July 18.
“The extension will give us time to reach a potential agreement,” Simpson said. “We are optimistic that we will make progress to negotiate a higher reimbursement rate, allowing us to keep care local for our Anthem patients in the communities we serve.”
She said the new contract termination date is Aug. 1.
“Over the past five months, we have been negotiating in good faith with Anthem and we were unable to reach an agreement,” Simpson added. “We cannot afford to continue caring for Anthem members without a substantial increase in payments. We have offered Anthem fair agreements, yet they refuse to work with us in a meaningful way.”
Michael Bowman, spokesperson for Anthem, also confirmed the extension.
“Adventist facilities remain in-network for Anthem members through that date as negotiations continue. In the event of a termination with Adventist, Anthem has taken steps and has policies in place to ensure our members continue to have access to affordable, quality health care,” he said.
Bowman said the contract negotiation is specific to commercial health plan members (employer-based, self-insured PPOs, HMOs, EPOs). Members who have Medicare Part C are also affected, however, those with a Medicare supplemental policy for Part A and Part B (Medigap) are not affected by this negotiation.
However, at least one local resident with a CalPERS Anthem Blue Cross supplemental policy for Medicare received a letter dated July 15 noting that “Adventist Healthcare is leaving your plan’s network.” Anthem’s customer service staff noted that this letter was sent in error.
Bowman encouraged any Anthem Blue Cross members with questions about their coverage to call the customer service number on their membership card or number on any letters received to learn more about their coverage status.
“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,” Bowman. “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. We are hopeful to reach an agreement with Adventist.”
Claudia Elliott is a freelance journalist and former editor of the Tehachapi News. She lives in Tehachapi and can be reached by email: [email protected]
