Lodi Adventist drops Blue Shield insurance [Lodi News-Sentinel, Calif.]

Lodi News-Sentinel (CA)

Dec. 8—Blue Shield members in Lodi will have to find another hospital or change health insurance providers for care.

The nonprofit health insurance company and Adventist Health of California have both announced that contract negotiations failed, and as of Dec. 1, the latter became an out-of-network provider for Blue Shield patients.

Adventist Health Lodi Memorial Hospital said the contract termination only affects hospital care and services. The outpatient clinic will continue to provide in-network services to Blue Shield members until March 2024, when that contract ends.

The hospital's wound care, urgent care, Fairmont Specialty and Galt Multi-Specialty clinics are hospital-based services, and are now considered out-of-network for Blue Shield patients.

Scott Nariyoshi, spokesman for Adventist Health Lodi Memorial, said it is unknown how many Blue Shield members were effected by the contract termination.

Contract negotiations have been ongoing for the last 11 months, and Adventist Health said it was asking for a small increase over its current rate to support high inflation costs of providing care in all the communities it serves.

According to Adventist Health, Blue Shield of California increased its premiums by more than 8.7%-15% for 2024.

"We are deeply disappointed that we are unable to reach an agreement with Blue Shield," the hospital said. "We want to emphasize that patients can always come to Adventist Health Lodi Memorial for medical emergencies, regardless of their insurance coverage or ability to pay. Blue Shield should cover all emergency visits to the hospital. We hope established patients will continue to see their physicians at our Adventist Health clinics as we continue contract negotiations."

The hospital said Blue Shield members should call the customer service number on their insurance card and ask about continuity of service.

It added that Adventist Health remains open to discussions with Blue Shield and will provide an update if anything changes.

In a statement released by Blue Shield last week, the health insurance carrier said Adventist Health wanted to end the network relationship and negotiate a new contract for its hospital facilities nearly a year ago.

Blue Shield said it negotiated in good faith with Adventist Health to establish a contract that was sufficient to cover the cost of providing access to quality health care, and that would enable the insurance carrier to offer competitively priced coverage to members. It said the hospital's requests made that impossible.

"As a tax paying, nonprofit health plan, Blue Shield's mission is to provide access to quality health care at an affordable price, and we have met our limit on what Blue Shield is able, and our members are willing, to pay for health care," Blue Shield said. "We are disappointed to have not been able to reach a new agreement with Adventist Health following their notice to terminate our existing contract, and we regret the inconvenience this causes our customers and members.

Blue Shield said it has notified its members and has taken steps to ensure they will have uninterrupted access to medical care in their area. A telephone call asking how many Adventist Health members would be affected was not returned.

For more information, visit AdventistHealth.org/KeepCareLocal.

___

Visit the Lodi News-Sentinel (Lodi, Calif.) at www.lodinews.com

Distributed by Tribune Content Agency, LLC.