FRESNO, Calif. (KSEE/KGPE) – Health insurance from three major carriers is currently not accepted by Community Health Systems after contracts between them expired at the end of 2022.
As of December 31, 2022, anyone with Anthem Blue Cross, Cigna, or United Healthcare will find that their health insurance is not covered at Community Regional Medical Center (CRMC), Fresno Heart & Surgical Hospital, or Clovis Community Medical Center. Without a new deal, Community Medicals Centers’ facilities will be considered an out-of-network provider.
On the insurance plan information page on their website, Community Medical Centers officials say health plans continue to raise premiums – while offering reimbursement increases that don’t come close to the current rate of inflation.
On its website, Community Medical Centers states that “insurers have reaped billions in profits during COVID-19, while hospitals continue to struggle financially,” citing examples such as wage inflation, labor shortages, and contracted labor. With that in mind they are asking health plans to acknowledge “the unprecedented cost challenges of delivering care” and come together to reach fair and reasonable agreements.
Both United Healthcare and Anthem Blue Cross sent statements to YourCentralValley.com on the negotiations. They say that the deal Community Medical Centers is looking for is “unreasonable” – adding that agreeing to what they are asking for would cause a significant financial demand on families and businesses. Cigna did not respond to a request for comment.
“The increases being sought by Community Medical Centers are unsustainable and will lead to unnecessary cost increases for health care consumers and result in higher premiums, deductibles and copays for local employers and families.
“Agreeing to those terms would create a significant financial burden for families and businesses as a majority of those we serve are covered by self-funded plans – meaning they directly pay for their medical expenses. Businesses and families across our state are already impacted by high inflation, which is why we cannot concede to requests for drastic cost increases.”– Anthem Blue Cross spokesperson
“Over the past several months, we’ve made numerous attempts to compromise and find solutions as part of good-faith negotiations. Unfortunately, Community Medical Centers’ current unreasonable demands would result in significantly higher health care costs for Fresno-area residents and employers. We’ve offered Community Medical Centers market-competitive rate increases that will ensure its hospitals and facilities continue to be fairly compensated for the care they provide to our members.– United Healthcare spokesperson
Community Medical Centers officials say they are continuing good-faith discussions with the health plans, despite the expired contracts to reach an agreement. Anthem and United Healthcare both also echoed that sentiment saying that they are also working diligently in good faith to come up with an agreement to get new contracts done.