Health coverage compromised at Dignity Health hospitals amid contract dispute

August 6, 2021

By JOSH FRIEDMAN

Central Coast residents insured by Anthem Blue Cross recently lost most of their health coverage at a few local hospitals amid a contract dispute between the insurance company and the nonprofit Dignity Health. [New Times]

As of July 16, Anthem Blue Cross customers no longer have in-network coverage at French Hospital Medical Center in San Luis Obispo, Arroyo Grande Community Hospital and Marian Regional Medical Center in Santa Maria, each of which is part of Dignity Health’s system. Anthem Blue Cross and Dignity Health have been negotiating new contracts for six months, and each side is faulting the other for failing to agree to a deal.

Patients can still access Dignity Health facilities for emergency medical services, an Anthem spokesperson said. Anthem is also providing transition assistance to pregnant women and patients who are undergoing treatment or who have prior authorization for Dignity Health to ensure a continuum of care.

With negotiations ongoing, Anthem says Dignity Health charges too high of rates.

“The problem is Dignity’s rates are sometimes the highest among all health systems in California, making it almost 30 percent more expensive than other health systems in the state,” the insurance company said in a statement. “We don’t think our members and customers should pay substantially more for health care at Dignity when they can receive quality care from the many other providers in our network, and we are working to fix that.”

Anthem says it recognizes the fact that costs do rise, which is why it offered Dignity increases over current rates.

Dignity Health President/CEO Dr. Robert Quinn said his nonprofit made a proposal to Anthem with rates that do not even cover hospital inflation costs and are below increases included in prior agreements.

“Dignity Health is a nonprofit health care system and California’s largest Medicaid provider and has lost money in recent years, while Anthem is a for-profit insurance company that earns billions of dollars in profits,” Quinn said in a statement.

The two sides remain in active discussions and hope to reach a new agreement soon, Quinn said.


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Francesca Bolognini

Wow. OK, just so very baffled by how few of you get what is being done to you. So busy blaming “the other party” (both of them really) you don’t see how badly this racket is ripping you off no matter what you do.


Because of my work, I have had the experience for many years of talking with visitors from other countries about the quality of their health care. They all think we are both ignorant and out of our minds in this country and I have to totally agree with them. All other developed countries pay a fraction of what we do here while getting far superior – not marginally better – far superior care. Every other modern, developed nation has single payer health care, no one has to go uncovered and they ALL pay much less for this than we do for the crappy situation we have here.. They are making us look like total idiots for allowing ourselves to be robbed by insurance companies and bankrupted by medical bills while having a staggering number of people having to choose between rent, eating and medical care or none of the above.


Stop squabbling amongst yourselves over things. Most of you are obviously confused and resorting to partisan talking points. Get angry that we are not enjoying the benefits of the society we deserve for the amount of work we are putting in. Most of us are underpaid to begin with. Insurance companies don’t even sell a product, they just take your money and deny you access to what you are paying for. And don’t get me started on drug companies.


Wise up. Get their money out of politics and demand better.. There are excellent, proven health care systems all over the world, over one hundred to choose from. It is embarrassing to see America so far behind on something that was once the pride of our country.


derasmus

So just so I understand you, if you need open heart surgery, or a hip replacement. Or have a complicated cancer, please name the specific country that would have a better patient outcome.


And this is why folks from Canada are lining up at the Cleveland Clinic or John’s Hopkins for complicated stuff.


However, I get your point and I don’t disagree with you completely. The insurance companies are ripping us all off, not just in health but auto, and home. Perhaps we need to start addressing tort liability and asking why a bandaid cost $10 or a simple cloth arm sling that cost $12 at Rite Aid cost $140 at an outpatient surgery center. Who is getting rich off this?


Francesca Bolognini

Well, to answer your first question, likely the Netherlands or any Scandinavian country, they always make the top of the lists, although we rank quite far down in quality of health care, so likely several others as well, such as Singapore, which ranks #1, currently. We are always below at least 25 and often far lower, of the more than 125 countries with universal health care.


In any one of those developed nations, you would never be financially burdened in the least by treatment for any of the conditions you mentioned, or, any other non-elective treatment. The overall cost for these programs is shockingly lower than what we pay in this country. I have not heard a lot about people “lining up” for treatment who come here from other countries, but I am very familiar with how often Americans are forced to travel abroad for their care simply to find quality, affordable and lifesaving procedures Mexico is doing a land office business over the border on Americans who need dental work, for instance.


There are more than a hundred blueprints for a successful system. None of these countries would choose to go back or have our current system instead. None. There is no excuse for not having universal health care in America, besides the funding our politicians receive from the sociopathic middlemen we allow to exist here.


And I would agree that this problem now extends to all other types of insurance as well to some degree.


derasmus

So, when the late King Hussein of Jordan flew his private jet to the Mayo Clinic he must have passed over the countries you listed because…? Maybe he got a better deal? Oops, that can’t be, he was worth a few hundred million.


And last week when I was talking to a friend who works at the John Wayne (now St. John’s) Cancer institute he was telling me about all of the European and Canadian citizens they see daily.


But you go ahead and fly off to Singapore or the Netherlands when something really complicated happens.


LOL


IDBOUND

A friend tested positive for Covid this week. Doctor gave him a 51% survival rating and sent him home to tough it out.My friends self employment and his lousy medical insurance he’s paid for with good hard earned money for will not pay for any hospital care for covid .I suggested if the need arises that he requires hospital care that he should go to a large city in Calif and check himself into a hospital with a fake name as an undocumented person illegally in the USA so that he will be hospitalized without the possibly having to file for bankruptcy should he live to see a future existence


mazin

Stop the undocumented resentment and side show diversion. We got it. You don’t like the undocumented. Yeppers, they are desperate poor people. Easy to kick.

I would have your friend call Sierra Vista in San Luis Obispo (805) 546-7600, Cottage in Santa Barbara (805) 541-9113. Heard they are both accepting Anthem.


modernwelding

Afraid there is going to be a lot of people wishing they got fully vaccinated soon :(


slo-to-load

Sure, blame the “undocumented” for your “friend’s” COVID infection. I’m sure it had nothing to do with the fact that your friend refused get vaccinated, wear a mask or social distance.


Ricky2

It’s not just hospital care that’s affected. Dignity has gobbled up many medical practices, so if your doctor is in one of those, your office visit is now “out of network” and you pay for it, not your now worthless insurance.


mazin

“Continuum of care” is a legal requirement, with continuous care uncertain unless the requirements are met.


Rambunctious

I thought Obamacare or the ACA was suppose to fix this…..


805thirdeye

It was, until former President Trump and his administration repealed the ‘Affordable Care Act’ also known as ObamaCare.


derasmus

The didn’t repeal it. They were only able to get the mandate neutered. For the most part the ACA is still in place. I know people who rave about it and some who are still angered by it. A real mixed bag and depends on who you ask.


Ben Daho

Can you explain what that means?


mazin

This is a dispute between a private insurance plan and a contracted private provider. I suppose employers providing health coverage through the Anthem Blue Cross system could opt out, with the employees selecting the Obamacare option in the future. Nice to have the Obamacare backup.


Robert1

Nice to have the Obamacare backup……. at the expense of your neighbors..shame on you.


Ben Daho

People say they are patriots. What does that mean? They love America? What part? The stones and valleys? The mountains? What about the people? Don’t they count? Don’t Americans like you count?


They take OUR money out our pay our entire lives. Every Nickle we make has part of it taken out.


Part of it goes the the State employees, County employees, City employees, Military and ALL government contractors and their employees and spouses medical insurance gets part of that money that we earned, Government grants, farm and job Subsidize programs, Special Districts, State Police, CHP, Correctional Officers, DMV, CASA, Swat, School Teachers, Etc. and that’s fine, It’s just fine. Not even a question.


ALL of their pay AND health benefits are paid for by YOU and I, But if it’s even suggested that anyone else that needs some help it’s suddenly outrageous and the decline of capitalism. all of our roads, City, State, Federal. were paid for with our own money. School buildings, City Hall, The County Buildings, Airport, Paid for by US, but if someone isn’t able to get a job at any of those tax payer funded jobs, they are mocked and ridiculed and excoriated for trying to get what MILLIONS of other people get handed to them just by passing a job interview.


We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquillity, provide for the common defence, PROMOTE THE GENERAL WELFARE, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.


Just asking for what others get with our own money is bad? I don’t understand why people take a stand opposite of what would help our fellow Americans life healthier happier lives.


mazin

How so “at the expenses of your neighbors”?

About 31 million Americans now have health-care coverage through the Affordable Care Act, the White House announced Saturday, setting a record since the law, colloquially known as “Obamacare,” was enacted in 2010 under President Barack Obama. Jun 5, 2021

Shame on you.


Ben Daho

so, 10 of your neighbors work for CMC. they have the best EVERYTHING as far as benefits. since you didn’t get the job there, you only pay into their benefits through taxes. You’re not allowed to get ANYTHING towards your health care..


A few years ago, there was a short story swept under the rug about the hiring practices at the City of Slo. Someone with NO EXPERIENCE got hired and the person with over a decade of experience was passed over because the person that got the job was related and the excuse was “We’ve always done it that way”


So, the No experience person gets a packet of about 40 pages of benefits, but the person that got the “We’re sorry, good luck” just keeps paying into the healthcare of the person that took the job they were qualified and you say “at the expense of the neighbors”. do you ever think that maybe WE THE PEOPLE deserve what others have been handed ALSO? If you have kids or grandkids or yourself didn’t get a job because of some shady Hiring, is that ok? You just keep paying into the neighbors benefits and shush.


Robert1

Obamascare ruined healthcare as we know it, our company premiums have gone up every year since the socialist and illegal executive order was enacted.

Basically, the demo’s made it possible for the law to extort money from your neighbors and gifted it to the other neighbors who did not have healthcare, they forced us to cover and pay for those who had little or no coverage.


Ben Daho

The Heritage foundation drafted the ACA because WE were tired of people going to the emergency room for general Medical care and We the people paying for it. If you’ll do a few minutes research of the rising cost, you can then figure out why we needed something to happen/ https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#item-start


nospamthankyoumam

Just to point out that it is clear not one of you commenting under this thread have any idea about how health care works in America. By works I don’t mean what deductible, copayment, out-of-pocket minimum, premium, and open-enrollment period means. I mean, how the system is constructed and why. Because if you had any idea at all, you would either go very quiet for a while and then get quite upset, or you would scream and yell about it to your political representative, your friends and family, strangers in the street, etc. Because the health care system as currently constructed in America isn’t broken, it’s straight up corrupt. Dignity Health owns pretty much everything in town. They OWN the HOSPITALS. Do you understand what that means… you cannot go to the hospital if you want to. They LET you in. It’s their frickin’ hospital and there is nowhere else to go. And yes, they want you to give them your money to go in there. So maybe if you don’t like the terms you could shop around. NOPE! I just don’t understand why anyone thinks it’s OK for a monopoly to exist anywhere, but in our community’s hospitals! C’mon folks! I guess I should just move to the communist Soviet state and see how I like it over there shall I…


derasmus

It seems like this should be a violation of trust laws. Where is a TR when we need em…!


derasmus

Only if you are poor or indigent as many middle class working people who had decent insurance got screwed by the ACA. I know of many examples (10-20 plus) right here in this county


Rambunctious

Dignity is too big too expensive and too bloated…


Mark

Dignity, at least French Hospital, is a complete rip off. I went in for a pain in my abdomen because an urgent care doctor said he thought it might be my appendix. So I went to French ER. Long story short, I never saw a doctor–just a nurse and a PA–and I had one CT scan. Other than that, most sat in a room by myself for 4 hours. Turns out it was nothing, maybe just gas. LOL.


The bill? $13,000. $7,000 of that was for the scan. (As a comparison, my wife had roughly the same CT scan at Selma Carlson in SLO for $250.). Anthem picked up $7,000 of the bill. My deductible was $8,800. After negotiating with their collections office, I paid something like $4,200.


Hard to side with an insurance company, but I see what they are saying about Anthem being too expensive.


nospamthankyoumam

The outrageous thing about this story is that you went and ‘bought’ something and had NO WAY of knowing how much it cost until after you had bought it. Such a stupid system America. I just don’t understand why American’s think this is normal, never mind acceptable! You guys are the greatest consumers on the planet, your supposed to be good at buying stuff!


Ben Daho

Greatest consumers and Smart consumers are different.