Adventist Health, Anthem Blue Cross extend contract, still negotiating

The contract between the health care system and insurance company was due to expire at 12:01 a.m. Monday.

That situation left some local patients — particularly those who have the insurance through their employers — extremely concerned because of the potential for their insurance to no longer be accepted at Adventist Health facilities.

Kim Lewis, spokesperson for Adventist Health Clear Lake, told Lake County News on Monday that the two sides had agreed to the two-week extension.

"The extension will give us time to reach a potential agreement. 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," Lewis said.

She said the new contract termination date is Aug. 1.

On Monday, Anthem Blue Cross released its own statement on the situation.

It said: "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. 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 health care affordable for those we serve. Our hope is to reach an agreement with Adventist."

Anthem Blue Cross spokesman Michael Bowman also told Lake County News, "Our hope is to reach an agreement with Adventist prior to the current contract expiring, but if our efforts continue to be rebuked, we will work closely with our members to ensure they have continued access to quality care from any one of the many care providers in our network, including Sutter in Lakeport."

In June, Adventist Health sent a letter to patients, which also was posted on its website, explaining that its current contract with Anthem Blue Cross "is not sustainable, and we need to renegotiate our terms."

The hospital's letter continued, "As a not-for-profit, faith-inspired organization, we provide services in some of the poorest areas of California and throughout the past five years, have given away more than $276 million in charity care to those in need. Our commitment to the underserved has resulted in multiple years of negative operating financial performance. As a system, Adventist Health provides a hospital network across California and must have rate increases that support overall expenses that continue to exceed the reimbursement we receive."

Adventist said 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 other hospital systems. Anthem is one of our lowest paying health plans, and we can't continue to provide quality care for patients at significantly reduced rates."

In a statement issued on Thursday, July 14, Anthem Blue Cross said it's been negotiating in good faith in an attempt to retain Adventist Health in its care provider network. The company said it was due to have a meeting the next day, Friday, July 15.

"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. We've offered increases that are in line with what other provider partners receive for the same services, which will help keep health care affordable for those we serve. We believe our care providers should be reimbursed fairly, and that has been reflected in our offers during these negotiations," the statement said.

Adventist said it will continue to keep patients apprised of the situation in the coming days.

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