Anthem Blue Cross Negotiations with Scripps Health: Scripps Has Chosen to Leave Our San Diego Care Provider Network
December 31, 2024January 2025
Scripps Health has chosen to leave Anthem’s care provider network effective January 1, 2025. We want Scripps doctors and facilities to return to our network and remain in discussions to reach an agreement that offers affordable prices for the employers and consumers we serve—but we cannot agree to the extreme price increases Scripps seeks to charge patients covered by Anthem.
The decision by Scripps to leave Anthem’s network could affect the out-of-pocket obligations for our members who receive non-emergency care at Scripps doctors or facilities. Using hospitals, facilities and physicians that are out-of-network will lead to higher costs for members, which is why we always encourage them to seek care from providers that are in our care provider network.
While negotiations continue, we will continue directing members to our other in-network facilities and remain committed to ensuring members continue to receive the right care at the right time in the right setting.
Here’s Why This Happened?
For months, we’ve been working in good faith with Scripps to keep their doctors and hospitals in our network. As part of a new contract, Scripps was seeking to significantly increase the prices they charge patients covered by Anthem health plans. Agreeing to these demands by Scripps would create a significant financial burden for local families and businesses. These higher costs would lead to substantially higher out-of-pocket costs, deductibles, and copayments for our members and impact local employers and small businesses as well. More than 80% of Anthem members are covered by employers who pay directly for their employees’ healthcare bills.
Our Offer: Fair Payment Increases That Keep Care Affordable and Sustainable
We firmly believe our care providers should be reimbursed fairly, including Scripps, and that is reflected in our offers during these negotiations. Anthem has offered reasonable, above-inflation payment increases that keep health care affordable for our members. Our offers, which are consistent with payment increases in place with other California health systems, align with the State of California’s new spending targets, and more than cover the cost of providing quality care at their facilities.
Scripps rejected all offers from Anthem and made the decision to not extend the current agreement and terminate the contract.
Negotiations Continue
We continue to work in good faith to negotiate a new agreement for Scripps to remain in our network that includes reasonable payment increases that fairly compensate Scripps for the care they provide while also keeping care accessible and affordable for those we serve in San Diego County.
Does Anthem’s Network Include Other San Diego Health Systems?
Where can I go for information and updates?
We will update this website as negotiations continue. Anthem members may also login to the Sydney Health app or www.anthem.com/ca/ or call the Member Service Center at the number on their ID card for help finding alternative doctors and hospitals.
For months, we’ve been working in good faith with Scripps to keep their doctors and hospitals in our network. As part of a new contract, Scripps was seeking to significantly increase the prices they charge patients covered by Anthem health plans. Agreeing to these demands by Scripps would create a significant financial burden for local families and businesses. These higher costs would lead to substantially higher out-of-pocket costs, deductibles, and copayments for our members and impact local employers and small businesses as well. More than 80% of Anthem members are covered by employers who pay directly for their employees’ healthcare bills.
Our Offer: Fair Payment Increases That Keep Care Affordable and Sustainable
We firmly believe our care providers should be reimbursed fairly, including Scripps, and that is reflected in our offers during these negotiations. Anthem has offered reasonable, above-inflation payment increases that keep health care affordable for our members. Our offers, which are consistent with payment increases in place with other California health systems, align with the State of California’s new spending targets, and more than cover the cost of providing quality care at their facilities.
Scripps rejected all offers from Anthem and made the decision to not extend the current agreement and terminate the contract.
Negotiations Continue
We continue to work in good faith to negotiate a new agreement for Scripps to remain in our network that includes reasonable payment increases that fairly compensate Scripps for the care they provide while also keeping care accessible and affordable for those we serve in San Diego County.
Frequently Asked Questions
What Does This Mean for Anthem Health Plan Members?
Effective January 1, 2025, Scripps doctors and facilities are out-of-network for Anthem health plan members. This could affect the out-of-pocket obligations for Anthem members who receive non-emergency care at Scripps.
Effective January 1, 2025, Scripps doctors and facilities are out-of-network for Anthem health plan members. This could affect the out-of-pocket obligations for Anthem members who receive non-emergency care at Scripps.
Does Anthem’s Network Include Other San Diego Health Systems?
Yes. We offer members one of the largest care provider networks in the state. We have coordinated with our other local network partners to ensure our members continue to have access to high quality care including UC San Diego Health, Sharp HealthCare, Palomar Medical Center and others.
What if I’m being treated at Scripps and they leave Anthem’s network?
Our members are our priority. We know this is especially concerning for our members currently receiving care at Scripps. That’s why we have taken steps to help. If you were receiving treatment for a serious or complex condition prior to January 1, 2025, please contact our Member Service Center at the number on your Anthem ID card. You may be able to continue your care at Scripps for a limited time after January 1, 2025, if you are receiving certain types of care.
Our members are our priority. We know this is especially concerning for our members currently receiving care at Scripps. That’s why we have taken steps to help. If you were receiving treatment for a serious or complex condition prior to January 1, 2025, please contact our Member Service Center at the number on your Anthem ID card. You may be able to continue your care at Scripps for a limited time after January 1, 2025, if you are receiving certain types of care.
What should I do if I need emergency care from Scripps?
Emergency services are not affected. Members should always call 9-1-1 or go to the nearest emergency room in a life-threatening situation, even if that emergency room is not in our network. Coverage will be provided according to the member’s policy benefits and in-network cost shares.
Emergency services are not affected. Members should always call 9-1-1 or go to the nearest emergency room in a life-threatening situation, even if that emergency room is not in our network. Coverage will be provided according to the member’s policy benefits and in-network cost shares.
Where can I go for information and updates?
We will update this website as negotiations continue. Anthem members may also login to the Sydney Health app or www.anthem.com/ca/ or call the Member Service Center at the number on their ID card for help finding alternative doctors and hospitals.
