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Letter to the editor: Demand local coverage from Anthem PPO

Hazel Hawkins Memorial Hospital (HHMH), a special healthcare District, was forced to make the very difficult decision to end our contract with Anthem Blue Cross PPO and Anthem Medicare Advantage. This was not a decision taken lightly. 

Negotiations with Anthem for an appropriate payment rate have not been effective over the past few years. Unfortunately, a termination notice is the only tool we have to get Anthem’s attention. Access to quality healthcare is a right for the communities we serve, yet our organization must advocate for the financial stability of our District. 

This unfortunate situation is because Anthem Blue Cross, the second largest health insurer in the United States, refuses to pay Hazel Hawkins a market competitive rate for the services provided to patients covered by their PPO insurance products. Our current Anthem Blue Cross reimbursement is unsustainable and not only far below the rates we have with other health plans, but also below what we believe other neighboring hospitals receive. 

As you know, inflation has increased the cost of all goods and services, particularly for hospital 

services. Yet, Anthem expects us to provide care to its members without a comparable rate adjustment to account for the rise in inflation. We are not able to continue to accept these rates, since by doing so we would jeopardize our future viability. 

This is not a unique situation—other hospitals and health systems in the Bay Area have terminated contracts with Anthem for the same reason.

Anthem sent their San Benito County members a list of suggested hospitals where their members can receive “in-network” care. This message creates a risk to patients. Emergency Medicine and visits to the Emergency Department are not included in the Anthem contract termination. Traveling 30 minutes or more to receive care is not only a patient safety risk but a burden on our community members who seek routine diagnostic services. 

Anthem does not seem to understand the “out-of- network” impact on their members. Many patients struggle with transportation. Other Anthem members seek healthcare services during their work day and can’t afford to use time off to travel out of San Benito County. The unnecessary travel creates a hardship on patients, families and employers. This is unacceptable. 

Anthem Blue Cross members may continue to utilize services at HHMH. However, they will most likely incur higher co-pays, deductibles or share of cost. (It is important to emphasize access to Emergency Care is not affected by the contract termination.) 

We have established a dedicated team to help Anthem PPO and Anthem Medicare Advantage Members navigate access to care, provide continuity of care and offer payment options. We encourage you to contact our team at 831.205.5710. 

Hazel Hawkins Memorial Hospital is committed to doing what is right for the community and protecting the hospital by taking a stance on the unfair business practices of a mega for-profit corporation. We must ensure the long-term viability of healthcare in our community. 

We are asking for support from Anthem members. We encourage you to reach out to your employer or Anthem to express your concern. The Anthem number to call is 844.971.0117. You may also visit our website at hazelhawkins.com and click the News Tab to get more information on how you can advocate for Hazel Hawkins Memorial Hospital receiving a fair contract with Anthem Blue Cross. I also encourage you to visit our YouTube Channel to hear Steve Hannah, CEO, explain the reason for the Anthem Termination. 

Mark Robinson is CFO of Hazel Hawkins Memorial Hospital, located at 911 Sunset Drive in Hollister.