Salinas Valley Health Supports Patients

Media Contact: Karina Rusk
831-759-1843

July 28, 2023 ­–After months of negotiations, Anthem Blue Cross (Anthem), which is among the largest and most profitable insurance companies in the country, has denied every proposal by Salinas Valley Health and rejected offers by the local health care district to protect patients by temporarily extending the current contract to ensure patients do not experience a disruption in care. If an agreement is not reached by August 1, 2023, and Anthem continues to refuse to extend the contract, Salinas Valley Health and Anthem’s members, will be excluded from Anthem’s network. Salinas Valley Health is working diligently to reach agreement. 

“We are invested in the health of our patients and our community.” says Pete Delgado, Salinas Valley Health president/CEO. “Big insurance companies are leveraging their size and strength to increase rates on patients, generating record profits and yet seem unwilling to reimburse care providers for the cost and quality of the services we provide.”

Salinas Valley Health is committed to a resolution that benefits patients, the community and long-term sustainable success for the local public district healthcare system. It has been ten years since Salinas Valley Health has seen any change in its contract with Anthem, making it difficult to sustain inflationary pressures. Should Anthem, continue to decline each and every proposal and extension provided to them, Salinas Valley Health will treat patients as if they are in-network. In this worst case, out-of-network situation, nothing changes for the patient on August 1. It is not a long-term solution but it would allow time for patients and Salinas Valley Health to explore options.

“If Anthem will not do the right thing, Salinas Valley Health will,” said Delgado. “If we still have not reached agreement by August first, and Anthem continues to deny an extension of the current contract, we will treat patients within Salinas Valley Health Medical Center and Salinas Valley Health Clinics as in-network.”

In similar out-of-network scenarios that have played out across the county, Anthem patients are often required to bear a larger portion of the cost of receiving care when their provider of choice is forced out-of-network. The abrupt change can trigger higher out-of-pocket costs and deductibles than the in-network benefits consumers expected with the plan.

In a letter to Anthem, dated July 27, the County of Monterey Board of Supervisors weighed-in on the 11^th hour negotiations. The letter signed by Board Chair, Supervisor Luis Alejo reads in part, “The County of Monterey is the largest employer in the region, and we do not want to see our Anthem insured employees, nor our constituents, experience disruption in care or the terrifying prospect a contract termination would thrust upon the families in our region. Changing insurers is an option we hope will not become necessary.”

Anthem, a for-profit company with $8.5 billion in profits for 2022, has acknowledged the increased costs healthcare providers face across the country, as inflation, labor shortages and reductions in funding become a crushing weight for many. Anthem itself is raising insurance premiums on its members by double digits, prompting County Supervisors to ask the insurance giant, “Covered California just announced that Anthem is raising customer premiums by 11%. Where are the increased premium dollars going if not to the health systems providing care to those paying the premiums?” 

If Anthem excludes Salinas Valley Health from its network on August 1, the hospital district is offering patients time to understand how the change would impact them and will continue to bill patients at Salinas Valley Medical Center and Salinas Valley Health Clinics as if they were in-network. Salinas Valley Health encourages patients to know their options and medical care rights.

• Access to Salinas Valley Health Emergency Department. The law protects patient access to emergency rooms. Visiting the Emergency Department at Salinas Valley Health for emergency care will continue to be considered in network for Anthem members.
• Apply for Continuity of Care. Patients who are pregnant or undergoing active treatment for a chronic condition may quality for extended in network access through Anthem Blue Cross and are urged to call the number on the back of their insurance card.
• Make their voices heard. Patients suffer when they pay double digit rate increases and have fewer options to receive the medical care they want and deserve. Patients can fight back by calling the number on the back of their insurance card and request Anthem maintain in-network access to Salinas Valley Health.
• Consider other health insurance. Salinas Valley Health is in-network with many other health plans in the market. Patients who receive health insurance through their employer can contact the benefits manager to urge Anthem to keep Salinas Valley Health in-network.

Patients enrolled in Anthem plans who have questions about their coverage may contact Salinas Valley Health at 831-202-6870 or visit http://www.youdeservecoverage.com/ for additional information and Anthem’s continuity of care forms.