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Dignity, Anthem settle health coverage dispute

By   /   Tuesday, August 17th, 2021  /   Comments Off on Dignity, Anthem settle health coverage dispute

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Marian Regional Medical Center in Santa Maria is one of five Dignity Health hospitals in the tri-county region. (file photo)

Dignity Health and Anthem Blue Cross have reached a new multi-year contract agreement that allows Anthem-insured customers to maintain in-network access to Dignity Health providers and facilities.

On Aug. 16, the two organizations announced the agreement, which returns Dignity Health providers in the Tri-Counties to Anthem health plans, with no gap in coverage. The contract between Anthem and Dignity expired July 15, but the Aug. 16 agreement is retroactive to July 15. It will remain in place through April 30, 2025, according to Anthem.

Dignity Health, a San Francisco-based nonprofit, is the largest hospital network in the tri-county region. It includes French Hospital Medical Center in San Luis Obispo, Marian Regional Medical Center in Santa Maria, Marian Regional Medical Center Arroyo Grande, St. John’s Regional Medical Center in Oxnard and St. John’s Hospital in Camarillo.

“We are pleased to continue working with Dignity,” John Pickett, regional vice president of provider solutions at Anthem Blue Cross, said in a news release. “While we understand this wasn’t easy for consumers, it was necessary for us to stand firm as part of our efforts to help slow the sharp rise in health care costs.”

In July, Anthem told its members that some Dignity facilities and physician groups were no longer part of Anthem health plans, after the two organizations failed to renegotiate a contract agreement. Dignity Health rates were some of the highest among all health systems in California, according to a news release from Anthem.

“We value our relationships with providers, which are important to creating choices for our consumers and fulfilling our mission of improving lives and communities,” Pickett said. “Our members remained our No. 1 priority as we worked hard and in good faith to find common ground and reach an agreement with Dignity that helps protect affordability.”

People that made arrangements to receive care from other providers have the option to return to a Dignity Health provider, according to Dignity.

“This is a win for our patients who deserve access to local high-quality care,” Robert Quinn, CEO of Dignity Health Medical Foundation, said in a statement. “We deeply appreciate the patience of our patients, employers and physicians as we have worked through this process.”

The agreement ensures the health care system can continue providing care for Anthem members, Quinn said.

Anthem clients were able to receive in-network care from Dignity Health for several years and will retain that ability through at least 2025.

“From the beginning, our goal in working with Anthem has always been about ensuring we can continue to meet the needs of our patients today and in the future,” Quinn said.

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