Thousands of Sutter Health patients on the Peninsula may have to seek new health care providers soon, as a contract between Anthem Blue Cross and the medical network is set to expire Jan. 1.
According to a statement from a Sutter Health spokesperson, Anthem had notified the 16,000 Northern California patients with health care maintenance organization plans that they will be reassigned to non-Sutter doctors as of the new year, despite its current agreement “that would have allowed these patients to keep their Sutter doctors for up to six months.”
The continuity of care provision allows patients with certain needs to keep accessing Sutter care for an extended period of time but only with Anthem approval. Pregnancy, care for young children, as well as treatment for certain illnesses, such as pneumonia or a terminal illness, may qualify for continuity of care, according to the Sutter Health website.
Patients with Medi-Cal, exclusive provider organization and preferred provider organization plans would be able to continue seeing Sutter doctors at in-network rates until June 2025, the statement said, assuming a new contract has not been reached.
“While we remain optimistic about establishing a new agreement, if one cannot be reached before our current contract expires, we will assist our members in transitioning care to one of the many other in-network care providers in the San Mateo area,” an Anthem Blue Cross spokesperson said in an emailed statement. “We are also assuring our members who are currently in treatment at Sutter for serious and/or complex conditions that they may be able to continue care with their current provider for a limited time even if a new agreement is not reached.”
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A Sutter Health spokesperson said they are continuing to work on an agreement with Anthem that will allow patients to keep accessing their physicians “while covering the cost to deliver that care.”
“We hope Anthem is willing to continue productive discussions that prioritize patients’ access to care as we continue toward a renewed contract,” according to the statement.
There are more than 10 Sutter Health centers in San Mateo County, including Mills Health Center and San Mateo Care Center.
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