UPDATE: MemorialCare, Anthem Blue Cross Reach Contract Agreement

UPDATE | MemorialCare and Anthem Blue Cross have reached a contract agreement and Anthem members will not experience any disruption to their service, it was announced late Friday afternoon.

Lori Weaver, executive director of Managed Care at MemorialCare Health System, provided the following statement regarding the matter:

“We are pleased to announce that MemorialCare has reached a definitive agreement with Anthem for our hospital contracts. Effective retroactively to August 15, 2017, MemorialCare hospitals continue to be in-network providers for all Anthem members, allowing our patients and community to continue to receive uninterrupted, exceptional care. We’re reassured that Anthem continues to recognize that MemorialCare is a vital medical resource to the community.”

MemorialCare will continue to offer its Patient Financial Services Concierge at (714) 377-6897 for patients, doctors and community members for any concerns or questions they may have.

Colin Manning, regional and state public relations staff vice president for Anthem, also provided a statement on the matter from Anthem Blue Cross President Brian Ternan:

“Anthem Blue Cross is pleased to have reached a three-year agreement that will ensure our members have access to MemorialCare facilities. We’re sorry for any inconvenience the termination of our previous contract may have caused our members, but today’s agreement will help ensure stability going forward. It’s important to our members that we achieve the appropriate balance between access and affordability, and we’ve done that with this new agreement,” said Ternan.

Upon hearing the news, local elected officials took to social media and promptly emailed statements in approval of the latest developments.

“I applaud Anthem Blue Cross and Long Beach Memorial Medical Center for coming back to the table and reaching an agreement as quickly as they did,” Assemblyman Patrick O’Donnell said. “The news of the split was shocking and unnerving, and patients deserve to be able to count on reliable and accessible health care. I have been assured that patients can expect no disruption of services at this point, which should mean no out-of-network costs and no more confusion. This is the kind of efficient and effective resolution we can be proud of.”

Previously: Anthem Blue Cross, Memorial Care Network Terminate Contract Amid Negotiations to Renew

 

Long Beach Memorial and Anthem Blue Cross have unexpectedly severed ties resulting in some patients not being able to continue care at the Memorial Care Network. 

8/23/17 at 1:55PM | By: Jason Ruiz | A letter sent to customers of Anthem Blue Cross this week notifying them that they would no longer be accepted at Long Beach Memorial Hospital has prompted outrage from a local California State Assembly member.

The letter, closing coverage to some customers, comes amid contract negotiations between Anthem and Memorial. The short notice and ensuing reactions from enrollees led Assemblyman Patrick O’Donnell to issue a statement regarding the decision by Anthem.

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O’Donnell’s office was tipped off to the letter when constituents began contacting his office this week. The letter, dated August 15, was received by customers a few days ago with alternate sites listed for enrollees to obtain future care. In a statement, O’Donnell condemned the move and called for a reversal by Anthem on the decision to cut coverage for some of its customers at Long Beach Memorial.

“I am outraged to learn that thousands of families will no longer be served by Long Beach Memorial Medical Center if Anthem Blue Cross is their healthcare provider,” O’Donnell said in a statement. “I call on Anthem Blue Cross to immediately reinstate the Long Beach Memorial Medical Center and complete its mission of providing the responsible and adequate health care that enrollees have come to expect. Anthem Blue Cross should negotiate with Long Beach Memorial Medical Center, not patient lives.”

The letter, forwarded by O’Donnell’s office to the Post, states that Long Beach Memorial is no longer a participating provider in the Anthem Blue Cross network effective August 15.

“Anthem Blue Cross physicians who admit to Long Beach Memorial Care Center have been notified of this development and will arrange for admission of members to alternative facilities,” the letter states.

Some of the closest alternatives listed are St. Mary’s Medical Center in Long Beach as well as Los Alamitos and Lakewood Medical Centers. The letter also states that the change does not affect emergency medical services. So, those covered under Anthem Blue Cross would still be allowed to receive services at Long Beach Memorial in an emergency and have the services covered under their policy agreements, according to the letter.

The breakdown in negotiations between the two entities does not seem poised to interrupt coverage of employees who have coverage for themselves or their dependents through Anthem Blue Cross.

It is unknown how many patients will actually be affected by Anthem’s decision. Questions referred to Anthem representatives about the decision to sever ties with Memorial Care and how many of its policy holders would be affected had gone unanswered at the time of publication. In a statement, Colin Manning, staff vice president of regional and state public relations, blamed Memorial Care for the breakdown in negotiations and said that Anthem is willing to return to good faith discussions "when Memorial Care is ready." 

“Anthem is disappointed that MemorialCare chose to terminate their contract with Anthem in order to demand an excessive increase in reimbursement rates," Manning said. "Anthem has been in discussions with MemorialCare for months in an attempt to resolve this matter. Discussions continued until the eleventh hour when MemorialCare made the decision to terminate the Anthem contract with its five hospitals. We’re disappointed we were not able to reach an agreement with MemorialCare that would allow us to achieve the appropriate balance between access and affordability for our members."

News of the breakup comes weeks after Memorial Care hospitals were recognized by U.S. News & World Report and Long Beach Memorial ranked as one of the seven best hospitals in Southern California. Manning said that Anthem's contracts with the nearly 40 other hospitals in the region will help ensure that its members continue to get quality, affordable healthcare. 

An email circulated to Memorial Care employees Tuesday and obtained by the Post sought to clarify the information that had been circulated stating that Anthem’s pulling out was a blanket decision that affected all enrollees.

The email stated that employees and their dependents covered under Anthem plans (HMO, PPO and Vivity, its three-year-old program specific to Los Angeles and Orange counties) would not see changes in their coverage, labeling the information being circulated in recent days as “inaccurate”.

It did note that the Memorial Care System’s agreement with Anthem had terminated after six months of negotiations but the two are still working toward a resolution. In the meantime, those non-employees covered under Anthem who wish to continue receiving treatment within the Memorial Care network have some options, according to the email.

HMO members will continue to receive authorizations for care at Memorial, exclusive provider organization (EPO) and preferred provider organization (PPO) plan holders can request continuity of care authorizations from Anthem to be treated under in-network benefits. The email states that if PPO members have out-of-network benefits and/or a continuity of care authorization can’t be obtained, Memorial Care will honor the in-network co-payments and deductibles “so that the member is not financially impacted” by accessing benefits at a now out-of-network hospital.

In a statement, Lori Weaver, executive director of managed care at Memorial Care, apologized for the confusion brought about by the hospital’s contract negotiations with Anthem. Weaver added that Boeing employees and those Anthem Medicare patients will not be affected by the contract termination.

“We are asking Anthem to recognize and honor the value and importance of the services we provide to our communities on behalf of our patients, our physicians and our hospitals and that we [Memorial Care] are reimbursed fairly for the exceptional medical care we offer to the Anthem members that we serve,” Weaver said. “We recognize that some of our patients and physicians have received conflicting or confusing information from Anthem and we want to ensure that all of our patients’ questions and concerns are addressed so they can continue to receive high quality care. It is important to note that physicians’ contracts are remaining in place so patients do not need to change their physicians or interrupt scheduled services.”

Editors note: The story has been updated to include comments from Anthem.



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