With less than seven weeks until its contract with UC Health expires, Anthem Blue Cross says the San Francisco Bay Area health system has refused to accept rate increases and make administrative changes that it claims would simplify patient care.
More than 100,000 patients at UCSF Health and UCSF Benioff Children’s Hospitals stand to lose care in March if an agreement is not reached. Anthem Blue’s current contract with UC Health is set to expire on Feb. 29.
“We have offered UC Health reasonable payment increases that protect affordability and are in line with increases accepted by other health systems in California,” a spokesperson for Anthem said in a statement Thursday.
They added that Anthem has asked UC Health to work with the health care insurance provider “to simplify administrative and payment processes,” which it says would lower costs, speed up patient care and give providers more time with patients.
“Unfortunately, UC Health has refused to accept reasonable payment rate increases or to modernize administrative systems that would eliminate paperwork and burdensome administrative process[es],” the spokesperson said.
Both Anthem and UC Health issued statements earlier this month laying out their positions, with Anthem calling discussions that began more than a year ago “a standard, normal and routine part of the healthcare industry and something we take very seriously.” The insurance plan provider noted that nearly 80% of its members pay for medical expenses through self-insured, employer-sponsored benefit plans.
“It is imperative for us to negotiate on their behalf to help keep their health costs affordable and predictable,” Anthem said.
For its part, UC Health laid out its concerns and the stakes for thousands of affected patients, saying Anthem’s decision to terminate the current agreement was “jeopardizing in-network access to care” for its patients.
“UCSF Health needs a fair agreement with Anthem to maintain the standard of care you rely on,” the health system said. “As a trusted local care provider, we have a responsibility to ensure we are in the best position to provide high-quality care to our patients and community members. We are urging Anthem to protect the care you deserve.”
Should the contract—which has already been extended from an original Dec. 31, 2023, deadline—end without a resolution or extension, Anthem said it will take various steps, “including notifying members, regulatory agencies, physicians, and medical groups about the potential for a contract termination to ensure there are no gaps in care and all entities have ample time to prepare.”
On Thursday, a UC Health spokesperson took issue with both Anthem’s bargaining-table conduct and outreach efforts, saying it had agreed to the original extension and other concessions and believed an accord was within reach earlier this month.
“However, Anthem backed out on that agreement and added last-minute provisions that would have negatively impacted our patients’ ability to access care in our networks,” the spokesperson said in a statement. “UC would never sign an agreement that put those values at risk.
“Unfortunately, Anthem is now taking steps to transfer UC Health patients away from their current care providers and assign them to in-network providers of Anthem's choosing when the contract expires,” the spokesperson added.
Still, both parties said they are committed to negotiating a deal that will allow patients to continue accessing care at UC Health facilities with no gaps in coverage.
“Our commitment stands firm to establish a new agreement with UC Health, and we remain optimistic about a shared dedication to this objective,” the Anthem spokesperson said.