Enloe Medical Center, a 298-bed rural hospital in Chico, Calif., went out of network with Anthem Blue Cross Nov. 1 after the organizations could not negotiate a new contract, according to the Enterprise-Record.
Commercial Anthem Blue Cross members can no longer access the medical center at in-network rates. Policyholders with MediCal or Medicare coverage are not affected by the change.
Enloe CEO Mike Wiltermood told the Enterprise-Record that while the medical center began negotiating with Anthem in May, the two could not agree on physician payment rates. Mr. Wiltermood said that "Anthem hasn't given a contract increase in nine of the last 12 years" to Enloe physicians.
Mr. Wiltermood added when the organizations met Oct. 30, Anthem presented rates lower than what is outlined in their current contract. He said the health insurer is conducting similar negotiations with rural hospitals nationally that lack the same kind of negotiating leverage as large health systems.
In a statement to the Enterprise-Record, an Anthem spokesperson said: "Our priority during these ongoing negotiations with Enloe Medical Center continues to be protecting affordability for our consumers, while providing access to quality healthcare. We are negotiating in good faith to bring Enloe back into our network of care providers as soon as possible."
The insurer continued: "We do believe hospitals and doctors should be compensated fairly, and that has been reflected in our offers to Enloe. However, we cannot agree to rates that are not in line with what similar providers in the area receive. Those higher costs would be paid for by our consumers, many of whom are covered by self-funded plans and pay for their medical services directly."
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