Don't Panic Yet

We are getting to open enrollment season. Many UC employees and retirees have health insurance through Anthem Blue Cross and use UC health providers. However, there is a current contract dispute between UC Health and Anthem Blue Cross over the terms of continued coverage. It should be stressed, however, that such negotiations often reach agreement at the last minute. From the San Francisco Chronicle:

More than 600,000 Californians who get medical care at UC Health hospitals through Anthem Blue Cross ...may need to find a different health insurer or pay out-of-network rates for services at UC Health next year if the two parties cannot reach a new contract by February. UC Health and Anthem, two of California’s largest health industry players, are at odds over the terms of their future relationship. The current three-year contract was slated to expire at the end of December, but both sides last week agreed to extend the deadline to the end of February to allow more time for talks. 

Contract negotiations between health care providers and insurance companies are common and often involve disagreements over reimbursement rates. But the timing of this dispute is leaving many patients confused and frustrated because they are in their annual open enrollment period with their employers. The uncertainty over whether UC Health will remain in network with Anthem makes it hard to pick a health plan for next year. Those who want to continue seeing their same doctors at UC could choose to get coverage through another insurance provider, while those who wish to stick with Anthem Blue Cross could seek medical care elsewhere — meaning they’d likely have to find new doctors...

The number of patients who stand to be affected is also notable: The contract applies to all six UC Health academic hospitals which, in addition to UCSF, include UCLA Health, UC Davis Health, UC San Diego Health, UC Irvine Health and UC Riverside Health. It applies to Anthem Blue Cross PPO and HMO plans. 

Both sides declined to specify what terms they disagree about that are holding up a new deal. UC Health said Anthem terminated the agreement without cause, and only recently agreed to reopen talks. “We remain seriously concerned about Anthem’s decision to terminate the agreement and the potential impact on care for Californians,” said UC Health spokeswoman Heather Harper. An Anthem spokesman said such talks are a routine part of renegotiating contracts with providers and that the insurer is working in good faith to reach a new agreement with UC Health by the end of the year...

Full story at https://www.sfchronicle.com/health/article/uc-health-anthem-blue-cross-18431769.php.