July 18, 2 p.m.: Up against an expiration deadline early Monday morning, Adventist Health and Anthem Blue Cross agreed to a two week negotiating extension to prevent patients from losing their coverage at one of the Central Valley’s major hospital systems.
Adventist Health has hospitals in Bakersfield, Delano, Hanford, Reedley, Selma and Tulare. Anthem Blue Cross patients in Bakersfield and Delano have other hospitals as options, but the remainder of much of the southern Central Valley would have been left without care if the contract expired Monday.
Adventist Health announced the extension on its website and is optimistic that the two-week period will be enough time to reach a new deal.
The extension will terminate on Aug. 1 unless an agreement is reached beforehand.
“We are pleased to report that Adventist Health and Anthem Blue Cross of California have mutually agreed to a two-week extension of our contract,” Adventist Health said. “This extension will give us time to reach a potential agreement, and we are optimistic that we will make progress to negotiate a higher reimbursement rate – allowing us to keep local for our Anthem patients in the communities we serve.”
As noted by Adventist Health, the dispute between the two parties is centered on the reimbursement rate that Anthem Blue Cross pays.
The hospital needs the insurance giant to pay higher rates in order to support overall expenses “that continue to exceed the reimbursement we receive.”
“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,” Adventist Health said.
“Anthem is one of our lowest paying health plans, and we can’t continue to provide quality care for patients at significantly reduced rates.”
On the other hand, Anthem Blue Cross has argued that its requests have been reasonable as they have been accepted by other local hospitals.
“While we appreciate hospitals are facing labor, supply and other cost pressures, the reality is that employers across the country, including those we serve here in California, are facing those same pressures,” Anthem Blue Cross previously said in a statement.
“We’ve offered 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 believe our care providers should be reimbursed fairly for the care they provide, and that has been reflected in our offers to Adventist during these negotiations.”
July 17, 9 p.m.: Negotiations between insurance giant Anthem Blue Cross and Adventist Health appear fruitless with mere hours ahead of the expiration of a contract guaranteeing coverage for patients.
The contract for insurance coverage at Adventist facilities expires at 12:01 a.m. on Monday morning.
Sunday afternoon, an Adventist Health spokesman said that there were no updates regarding negotiations, with no deal struck between the two sides.
“We are doing everything to encourage Anthem to understand how important it is to keep care local,” Adventist Health spokesman Japhet De Oliveira said.
An expired contract will leave the hospital group, which operates facilities in Bakersfield, Delano, Hanford, Reedley, Selma, and Tulare, unable to see patients that carry Anthem Blue Cross.
For residents of the latter four cities, Adventist Health is the sole hospital within the territorial limits.
Adventist has cast Anthem’s proposal as merely padding profits while failing to adjust hospital reimbursement rates for increased labor and supply costs.
Anthem, on the other hand, has countered that its reimbursement rates have been recently accepted by a number of local hospital groups without such issue.
This story will be updated.
