Central Coast residents covered by Anthem Blue Cross are discovering that they cannot receive their regular in-network care at Dignity Health locations after a contract between the two entities was severed earlier this month.
This means that Marian Regional Medical Center in Santa Maria, as well as French Hospital Medical Center in San Luis Obispo and Arroyo Grande Community Hospital, along with surrounding Dignity Health Urgent Care centers, are no longer in-network for those covered by Anthem.
Anthem dropped Dignity Health from their network following months of contract-related disputes, during which time Dignity pushed for "excessive rate increases" despite already being nearly 30% more expensive than California's other health systems, Anthem said in a statement.
Anthem sent mailed notices to its affected members, which includes those enrolled in Commercial PPO, EPO, HMO and POS benefit plans as well as some Medicaid and Medicare Advantage plans, on July 16 advising them of the change.
“Unfortunately, Anthem would not agree to a new contract that would ensure we can sustain the services our patients and communities depend on. As a result, Dignity Health hospitals and physician offices are no longer considered in-network health care providers for Anthem PPO members effective July 15, 2021," the letter said.
Dignity Health officials stated that around 1 million California patients have lost in-network care at their locations because of the terminated contract, adding that they are a nonprofit health care system and the state's largest Medicaid provider.
"We remain in active discussions and hope to reach a responsible new agreement soon that will protect patients’ access to the care they need," said Dignity Health Medical Foundation President and CEO Robert Quinn. "New contracts with Anthem will let our doctors and nurses continue confronting the COVID-19 pandemic and providing essential services to our patients."
Dignity Health's contract proposal included rates that do not cover hospital inflation costs and are below increases included in prior agreements, Quinn added.
Anthem members in Santa Barbara County are advised to use alternate hospitals including Lompoc Valley Medical Center, Santa Barbara Cottage Hospital and Goleta Valley Cottage Hospital.
Members can also call the member services number on the back of their Anthem identification card to find out whether they qualify for continuity of care.
Anthem reminds members that emergency medical services are always considered a covered benefit and therefore do not require pre-authorization.