Enloe Terminates Commercial Contract with Anthem Blue Cross

Enloe Medical Center terminated its commercial contract at midnight with Anthem Blue Cross.

Posted: Nov. 1, 2018 6:13 PM
Updated: Nov. 2, 2018 4:14 PM

CHICO, Calif. – After weeks of discussion and negotiations between Enloe Medical Center and medical insurance giant Anthem Blue Cross, the two parties have failed to reach an agreement on a new contract. Enloe Medical Center representatives have announced the organization has terminated its contract with Anthem Blue Cross, effective Nov. 1, 2018.

The decision will affect countless numbers of insured; an estimated 10 percent of patients who are currently covered by Anthem Blue Cross insurance. The termination of the contract will also affect many physicians operating within the insurance network.  Ironically many employees of Enloe Medical Center are themselves covered by Anthem Blue Cross and will also be affected.

This termination does not affect Medicare or Medi-Cal patients.

Action News Now spoke to the C-E-O of Enloe Medical Center, Mike Wiltermood, for comment regarding the failed negotiations. He says despite weeks of outreach and threats of a possible termination, there was little negotiating on the part of Anthem Blue Cross.

“The lead negotiator for Anthem Blue Cross wasn’t there. They sent three individuals who didn’t understand our market. They had no concept of what we were talking about in terms of what services we provide, how far people would have to travel to find similar services.”

Wiltermood went on to say, “The fact is, Anthem has taken advantage of rural areas for years and years and years. We should have been talking about this a long time ago. I believe that Anthem’s strategy is to squeeze independent hospitals like ours and independent physicians as much as it can. Anthem has not given area physicians raises in nine of the last 12 years. When we talked to them about physician increases they said that that is off the table; they said it is a non-starter.”

Thursday evening, Nov. 1, 2018, Anthem Blue Cross sent Action News Now the following statement:

“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. In the meantime, consumers can access care at one of the many providers in the area who remain in our broad network.

“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.

“We understand consumers will have questions as these negotiations continue and we urged them to call the toll-free number on the back of their Anthem Blue Cross ID card as our customer service representatives are standing by to assist them.”

Action News Now asked Enloe Medical Center C-E-O Mike Wiltermood what the medical center’s policy is for anyone who comes in for treatment, but who are covered by Anthem Blue Cross.

“If the financial responsibility is too much, we’ll do everything we can to get them to a spot where, you know, whether it is Sacramento, the Bay Area or somewhere local, where they can get their services.”

Action News Now also asked what happens next in regards to emergency services.

“People need to know we definitely accept all emergency services and people that are in the middle of care, we need to maintain that continuity of care so that shouldn’t be a problem. I want to reassure everybody that if you have an accident if you have a medical emergency, we’re going to take care of you.”

Action News Now will continue to follow this developing story and offer updates if any agreements are reached.

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