Network Status Update: Sutter Health

 

Anthem Blue Cross (Anthem) and Sutter Health (Sutter) are actively engaged in mutual contract negotiations, as their current facility and professional contract agreements are set to expire on January 1, 2025. These discussions are a standard, normal and routine part of the health care industry and something we take very seriously.

 

As a long-time trusted health partner, we are committed to continuing our relationship with Sutter. Through honest and transparent negotiations, we aim to reach agreement on a new contract that focuses on confronting the escalating costs of health care and assures our members and customers continued access to affordable, superior care.

 

Anthem has been serving Californians for more than 86 years and we have had a long history of partnership with Sutter. We recognize that having in-network access to their local facilities is important to our members and customers throughout the State, which is why we continue to work in good faith to negotiate a new agreement that helps protect affordability and continued access to care at Sutter facilities and doctors.

 

 

 

A: The current facility and professional contract agreements between Anthem and Sutter are set to expire on January 1, 2025. Both parties are in active negotiations. Anthem remains firmly committed to reaching a new agreement that maintains our members’ access to long-term affordable care at Sutter doctors and hospitals.

 

A: Our commitment stands firm to establish a new agreement, and we remain optimistic about our shared dedication to this objective. In an event where an agreement is unfortunately not reached, Sutter doctors and facilities will be out-of-network for Anthem members effective January 1, 2025. This could affect the out-of-pocket obligations for Anthem members who receive non-emergency care at Sutter. We can assure our members that we have a substantial network of high-quality partners throughout the State prepared to provide care for members currently under Sutter.

 

 

A: In November, we notified some members who are enrolled in an Anthem HMO health plan and assigned to a Sutter Health primary care physician that they will be reassigned to a new physician, effective January 1, 2025, if a new agreement is not reached. These notices and actions are required by the State of California and are consistent with our efforts to ensure our members continue to have uninterrupted access to high-quality care if a new agreement with Sutter is not reached.

 

A: We know this is especially concerning for our members currently receiving care at Sutter. That’s why we’re taking steps to help in the event they leave our network. We are hopeful we can come to an agreement before December 31, 2024 – that is our top priority. But in the event that does not happen, we will ensure members have access to the care they need.

 

If a member is undergoing treatment at Sutter Health for a serious or complex medical condition that will continue past December 31, 2024, they may be able to continue care at Sutter after that date if they have an eligible condition under Continuity of Care. Members can contact Anthem Blue Cross at the toll-free customer service number, 1-844-971-0117, or the toll-free member services number on their ID card for assistance in submitting a request to continue care with their current healthcare provider.

 

A: Emergency care is covered and will be provided according to the member’s benefits. Anyone in need of emergency care should immediately go to the nearest emergency room or call 9-1-1.

 

Members who are seeking non-emergency care should look for services at a local in-network facility. Members can use the Sydney Health mobile app or access the Find Care function at www.anthem.com/ca to find in-network hospitals and doctors near them. Members can also call the toll-free member services number on the back of their Anthem member ID card for assistance.