LAKE COUNTY, Calif. — On Friday, Blue Shield of California and Adventist Health announced that they have settled their monthslong contract dispute that had resulted in Blue Shield members not having access to Adventist hospitals.
The contract between Blue Shield of California and Adventist Health Keep Care Local | Adventist Health provides Blue Shield members in-network access to all 18 Adventist hospitals across California.
In a joint statement, the two organizations reported that the new arrangement’s effective date is retroactive three weeks, to Dec. 1 — the date when the contract dispute resulted in Adventist Health hospital facilities no longer being part of Blue Shield’s network.
“As a mission-driven health plan, our goal is for our members to have access to quality care that’s sustainably affordable,” said Aliza Arjoyan, Blue Shield’s senior vice president of provider partnerships and network management. “Adventist Health has been a part of Blue Shield’s network of providers for a long time, and I look forward to continued collaboration with the hospital system.”
“We are pleased to continue our long-working relationship with Blue Shield of California,” says Kerry L. Heinrich, president and CEO. “Our mission calls us to provide access to high-quality care close to home in the communities we serve, and we are excited to continue caring for Blue Shield members.”
Adventist and Blue Shield have been in negotiations for nearly a year, and the attempts to come to a new contract broke down by the end of November.
On Monday, Kim Lewis, spokesperson for Adventist Health Clear Lake, told Lake County News that Adventist Health remained open to discussions.
Lewis said she couldn’t say how many Lake County residents were affected by the contract issues. “Blue Shield will not currently share the number of members with Adventist Health who are impacted. They are the only ones who have this information as the health insurance provider.”
Statewide, Blue Shield reported that it serves more than 4.8 million members through network relationships with about 350 hospitals and more than 122,000 providers across the state.
Then, on Tuesday, the Board of Supervisors approved a letter urging both sides to come to an agreement and pointing to Lake County’s low health rankings.
The letter recognized that transportation can be difficult for many in Lake County. Blue Shield had suggested by that point that its Lake County members travel to Enloe Medical Center or Oroville Hospital in Butte County, Queen of the Valley Medical Center in Napa County or Santa Rosa Memorial Hospital for Blue Shield facilities that can provide the care they need.
During that Tuesday discussion, Supervisor Bruno Sabatier pointed out that 51% of Lake County’s population is covered by Medi-Cal.
The letter was approved unanimously.
It explained, “While Blue Shield does not represent a large portion of the health coverage in Lake County it still represents a significant portion of our community members being impacted by this terminated contract. Lake County is 56th out of 58 counties when reviewing our health rankings in the State of California. Any action that breaks the continuity of care that our community members require exacerbates the health issues that we are already encountering across our county.”
Editor’s note: The article previously stated incorrectly that 51% of Lake County’s population is covered by Medicare, when in fact it is Medi-Cal.
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Blue Shield, Adventist reach new agreement for coverage
- Elizabeth Larson
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