For weeks, more than half a million Anthem Blue Cross enrollees who receive health care from the University of California were held in suspense. It wasn’t clear whether they would have to find new doctors or switch plans as the health system and one of its largest insurance partners struggled to reach agreement on a new contract.

UC Health accused Anthem of not negotiating in good faith, while Anthem leaders retorted that UC Health had demanded too much and rebuffed the insurer’s request for administrative efficiencies. In fact, roughly 8 million Anthem members in California were at risk of losing in-network access to UC Health’s vast network of prestigious hospitals and medical facilities, which could have left them with much higher out-of-pocket expenses. While not all patients were made aware of the situation, Anthem notified some enrollees they would be reassigned to new primary care doctors if no deal were reached.

But even as the parties announced an eleventh-hour agreement on Feb. 5, industry analysts say the conflict has become part of a trend in which patients are increasingly caught in the crossfire of contract disputes. Amid negotiations over rising labor and equipment costs, it’s often patients who are ultimately saddled with higher bills as the health industry continues to consolidate.

  • ChaosCoati@midwest.social
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    10 months ago

    We had this same thing to start the year. There’s one health system in our rural area. Last fall they notified us they might not be in-network for our insurance starting Jan. 1 because of failed contract negotiations. If they hadn’t reached an agreement the nearest in-network hospital or clinic would’ve been a 90 minute drive one way.

    I guess as a plus to this situation I did find out (through my own research) our state has laws setting a maximum distance we have to travel to reach in-network care. If the nearest one is further than that maximum we can go to a closer medical center and the insurance company is supposed to only charge us the in-network rate. But I definitely wasn’t looking forward to trying to get through all the red tape to actually get the price adjusted.