Salinas Valley Health Terminates Contract with Anthem Blue Cross While Demanding to Increase Health Care Cost for Anthem Members, Consumers and Employers in Monterey County
July 05, 2023August 1, 2023
Salinas Valley Health has chosen to terminate its contract with Anthem Blue Cross (Anthem), effective August 1, 2023. This includes Salinas Valley Memorial Hospital, Doctors on Duty Urgent Care and Salinas Valley Medical Clinics.
While we have been negotiating in good faith with Salinas Valley Health for several months, we have yet to come to agreement on a new contract. During this time we have offered Salinas Valley Health reasonable and fair rate increases, yet Salinas Valley Health has rejected all offers and remains steadfast in their efforts to significantly increase local health care costs for Anthem members, consumers, and employers in Monterey County.
The increases being sought by Salinas Valley Health are simply unsustainable and will result in higher premiums, deductibles, and copays for those we serve. They will also impact our employer groups whose employees make up more than 80 percent of Anthem’s volume at Salinas Valley Health. These are self-funded plans where businesses cover employee medical costs directly.
Anthem and Salinas Valley Health have a long history of partnership, and we recognize that having in-network access to their local network is important to our members. We firmly believe our care providers should be reimbursed fairly, and that is reflected in our offers during these negotiations. We remain committed to continuing to work in good faith to negotiate a new agreement that will help protect affordability and access for our members, and we hope Salinas Valley Health shares that commitment.
Why is this happening?
Contract discussions are a standard part of the health care industry and sometimes coming to agreement on affordability can take time. As a long-time trusted health partner, Anthem has been serving Californians for more than 85 years, including those here in the Salinas Valley. Maintaining stability in our network of local doctors and hospitals is extremely important to us, but we are also committed to ensuring our members have access to affordable health care. Salinas Valley Health wants to significantly raise prices for our members and customers – nearly three times the rate of inflation. Agreeing to those terms would create a significant financial burden for local families and businesses.
Now more than ever, as Californians are facing some of the highest inflation in decades, we need to ensure stability and continued access to affordable health care services. Any increases in local health care costs are dollars taken out of the pockets from local employers and families.
What does this mean for Anthem members?
As of August 1, 2023, Salinas Valley Health facilities are no longer part of Anthem’s provider network and will be out-of-network for Anthem members.
Other Local In-Network Facilities
Anthem Blue Cross members continue to enjoy in-network care at other local facilities in the area, including:
- Natividad Medical Center (Salinas)
- Community Hospital of the Monterey Peninsula (Monterey)
- Hazel Hawkins Memorial Hospital (Hollister)
- Watsonville Community Hospital (Watsonville)
Members who need help locating an in-network hospital, medical group, or urgent care center can call the toll-free member number listed on their Anthem member ID card or they can use the Find Care Tool at https://www.anthem.com/ca/find-care/.
Emergency Medical Care
Anthem members can still utilize Salinas Valley Health facilities for emergency services as emergency medical services are always considered in-network no matter where the care is provided. Anyone in need of emergency care should immediately go to the nearest emergency room or call 9-1-1. Coverage will be provided according to the member’s heath care policy benefits.
Continuity of Care
Transition assistance to ensure in-network continuity of care would be available for Anthem members who are pregnant, undergoing a course of treatment, or who have obtained a prior authorization for services. Members can call the member services number on their Anthem member ID card to find out if they are eligible for continuity of care.
Frequently Asked Questions
- What Anthem members are impacted?
- As of August 1, 2023, Salinas Valley Health facilities are no longer part of Anthem’s provider network. This could affect the out-of-pocket obligations for Anthem members enrolled in Commercial PPO, EPO, HMO, and POS benefit plans and receive non-emergency care at Salinas Valley Memorial Hospital, Doctors on Duty Urgent Care and Salinas Valley Medical Clinics. Doctors on Duty Urgent Care and Salinas Valley Medical Clinic will also be out-of-network for Anthem Medicare members as of August 1, 2023.
- As of August 1, 2023, Salinas Valley Health facilities are no longer part of Anthem’s provider network. This could affect the out-of-pocket obligations for Anthem members enrolled in Commercial PPO, EPO, HMO, and POS benefit plans and receive non-emergency care at Salinas Valley Memorial Hospital, Doctors on Duty Urgent Care and Salinas Valley Medical Clinics. Doctors on Duty Urgent Care and Salinas Valley Medical Clinic will also be out-of-network for Anthem Medicare members as of August 1, 2023.
- What other local facilities are in-network for Anthem members?
Anthem Blue Cross members continue to enjoy in-network care at the many other local care facilities in the area, including:
- Natividad Medical Center (Salinas)
- Community Hospital of the Monterey Peninsula (Monterey)
- Hazel Hawkins Memorial Hospital (Hollister)
- Watsonville Community Hospital (Watsonville)
Members can find other local in-network facilities and doctors with the Find Care function at www.anthem.com/ca or call the Anthem Blue Cross toll-free member services number on their ID card with any questions.
- What if an Anthem member needs emergency care?
- Regardless of a contract termination, Anthem members can continue to access Salinas Valley Health facilities for emergency services, as those services are always considered in-network regardless of where they are performed.
- Members seeking non-emergency care should look for services at a local in-network facility. Members can access the Find Care function at www.anthem.com/ca to locate a participating hospital in a specific area or call the toll-free member services number on the back of their Anthem member ID card.
- What about Anthem members who are in a current course of treatment at a Salinas Valley Health facility?
- Anthem members who are in a current course of treatment at a Salinas Valley Health facility will continue to receive those services.
- Certain Anthem members with certain medical conditions may qualify to continue their services under continuity of care at Salinas Valley for specified periods of time. Members may apply for this service.
- Anthem members who are authorized or scheduled for a service or procedure at Salinas Valley Memorial Hospital after August 1, 2023, will be notified and, absent approved continuity of care, the services will be transitioned to another in-network facility.
- On July 3, 2023, Anthem Blue Cross notified admitting HMO medical groups and physicians who maintain privileges/affiliations at Salinas Valley Memorial Hospital of the potential contract termination. Anthem encouraged these physicians and medical groups to obtain alternate admitting privileges and/or arrange for the redirection of members to alternate participating hospitals for non-emergency care services.
- Members can call Anthem Blue Cross at the toll-free member services number on their ID card with any questions regarding their benefits.
Staying Informed
For the most up-to-date information continue to refer to this site. Members can also call the member services number on their Anthem member ID card with questions about their benefits.
