Profits over patients

Enloe stands up to bully Anthem; now, it’s the community’s turn

Chico and the rest of the North State are a veritable health care desert. Our region is short dozens of primary care providers, and we also are desperately deficient in specialty physicians.

Despite being a small metro, Chico and the surrounding region have an exceedingly difficult time attracting and retaining doctors, especially when it comes to establishing private practices. That’s why many specialists have chosen in recent years to partner with local hospitals—consolidating billing and other departments for efficiency. But the situation is bleak for those institutions as well—at least when it comes to rural facilities. Over the last eight years, about 90 such hospitals in the nation have closed. Hundreds of others are at risk of sharing the same fate.

There are a number of factors at play here, but one of the primary causes can be attributed to the abysmal reimbursement rates paid by private insurance carriers, including one of the largest in the nation, Anthem Blue Cross, a major player here in Butte County. The Indianapolis-based company has made headlines for its tendency to put profits over patients. Recall, if you will, about this time last year when it was fined millions of dollars for its longstanding record of failing to resolve consumer grievances in a timely manner.

Last week, the company cut ties with Enloe Medical Center—after the two parties could not come to an agreement on a new contract to keep the hospital in its network of providers. The move puts tens of thousands of area residents without access to the largest health care institution in our region. Emergency services as well as Medicare and Medi-Cal will still be covered, and there are “continuity of care” requirements for certain chronic conditions, but others will simply have to look elsewhere—or pay astronomical prices for out-of-network care.

Rural hospitals and other providers often get short shrift because of lack of competition among insurers. Anthem, arguably the largest in this area, is trying to bully its way into a sweet deal that would line its own coffers while contributing little to local health care. In the meantime, it’s the patients who are feeling the pain. If you’re one of them, we urge you to not be silent. Call and express your thoughts to Anthem Blue Cross at (888) 486-4227 or the Department of Managed Health Care at (888) 466-2219.