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Submitted URL: https://anthemcommonspirit.com/
Effective URL: https://www.mountain.commonspirit.org/anthem
Submission: On March 30 via api from US — Scanned from US

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PROTECTING YOUR HEALTHCARE ACCESS AND CHOICE

At CommonSpirit Health, we believe every patient deserves access to high-quality
healthcare from the doctors and nurses of their choice. As a mission-driven,
nonprofit health system, we work hard to ensure we can always meet our patients’
needs and bring essential medical services to our communities.


PROTECTING YOUR HEALTHCARE ACCESS AND CHOICE

At CommonSpirit Health, we believe every patient deserves access to high-quality
healthcare from the doctors and nurses of their choice. As a mission-driven,
nonprofit health system, we work hard to ensure we can always meet our patients’
needs and bring essential medical services to our communities.



Over the last several months, we have been actively negotiating with Anthem Blue
Cross Blue Shield Colorado – one of the largest profit-focused insurance
companies in the United States – to reach new agreements that put patients first
and keep our Colorado hospitals, clinics, physicians, and advance practice
providers in-network for our patients.

Unfortunately, Anthem has been unwilling to agree to new contracts that would
ensure our ability to continue to provide quality services now and in the
future. If Anthem does not agree to new contracts with CommonSpirit before May
1, 2024, thousands of patients with Anthem insurance will no longer have
in-network access to our Colorado hospitals, clinics, physicians, advance
practice providers, and services.

St. Elizabeth Hospital in Fort Morgan is the only exception to the termination
with Anthem on May 1, 2024. Only the hospital would remain in network until at
least July 11, 2024, due to a separate contractual agreement. All CommonSpirit
physicians, advanced practice providers, and other locations in Colorado such as
urgent care centers – as well as our other hospitals in Colorado – would be out
of network for patients with Anthem insurance beginning May 1, 2024.

We deeply value our patients and are doing everything we can to ensure we remain
in-network with Anthem. It is our hope that Anthem will agree to new,
responsible contracts that maintain patient access to essential services as well
as the physicians and advance practice providers they know and trust.

Take action


TAKE ACTION


YOU CAN TAKE ACTION TODAY TO PROTECT YOUR HEALTHCARE ACCESS AND CHOICE:

 * Call Anthem at the number on the back of your insurance card and urge Anthem
   to work with CommonSpirit doctors and nurses on a new agreement.
 * If you have insurance through your employer, talk to your human resources or
   benefits representative and urge them to contact Anthem. You may also want to
   ask them about alternate or secondary coverage options that will protect your
   in-network access to CommonSpirit hospitals, clinics, physicians and
   providers.
 * If you have additional questions about our efforts to remain in-network with
   Anthem that are not answered below, you may call 877-213-7081 to speak with a
   member of our team. Representatives are available 9am-9pm MT weekdays and
   9am-5pm MT on weekends.


PROTECTING ACCESS AND CHOICE

The hospitals in the CommonSpirit Mountain Region have been caring for our
Colorado communities for more than 140 years. As a nonprofit, mission-driven
health system, fair agreements with insurance companies give us the ability to
continue investing in our employees, caring for patients and ensuring access to
essential care.

We remain willing to negotiate with Anthem in good faith and have provided
multiple counter proposals in the negotiation. Our goals in working with Anthem
include:

 * Reach new agreement with Anthem to avoid disruption for patients and members
   of our community who are insured through Anthem.
 * Protect access to our physicians, providers, nurses, and essential services.
 * Ensure our ability to continue delivering on our mission and to provide
   quality services now and in the future.

If Anthem removes CommonSpirit’s Colorado hospitals, clinics, physicians and
providers from its network, access to care will be limited for consumers with
Anthem health insurance. For the patients and communities we serve, that will
mean:

 * Limited access and choice to CommonSpirit doctors and services.
 * Being forced to travel great distances to receive the care – especially
   specialized care – that patients are accustomed to.
 * CommonSpirit’s ability to provide even the most essential care to all
   patients, especially underserved patients in low-income communities, will be
   threatened.

Continuity of Care benefits

If Anthem and CommonSpirit are unable to reach an agreement before May 1, 2024,
patients who are currently in active treatment or have appointments or
procedures scheduled after that date may qualify for protected in-network access
through Continuity of Care benefits.

Continuity of Care is intended to protect patients from having to change
providers or having care delayed or disrupted if an agreement between a health
plan and provider is terminated. This benefit is a state law, and Anthem, like
all licensed health plans, must abide by the requirements.


HEALTH CARE CONDITIONS THAT MAY BE COVERED BY CONTINUITY OF CARE INCLUDE:

 * Prenatal/obstetrical care
 * Chemotherapy
 * Radiation therapy
 * Physical/occupational/speech therapy
 * Elective surgery
 * Ongoing treatment for an acute inpatient stay
 * Discharge planning after an acute inpatient stay, even if your previous
   health insurance carrier is still following your care
 * Dialysis
 * Home health care
 * Hospice care
 * Home IV therapy
 * Inpatient rehabilitation
 * Durable medical equipment
 * Supplies

You may save and fill out the Continuity of Care Request Form here.

Ask your doctor’s office if you need assistance with filling out the Continuity
of Care form. For questions about Continuity of Care eligibility, benefits, and
access to the form, please call Anthem using the number on the back of your
insurance card.

Frequently asked questions

WHO WOULD BE IMPACTED IF A NEW AGREEMENT BETWEEN COMMONSPIRIT HEALTH AND ANTHEM
IS NOT REACHED?

Unless we mutually agree with Anthem to new contracts, thousands of patients
with Anthem insurance will no longer have in-network access to CommonSpirit’s
hospitals, clinics, physicians & providers, and services in Colorado. This would
significantly reduce access to care and choice for patients with Anthem
insurance.

WHEN WOULD ANTHEM CONSIDER COMMONSPIRIT PROVIDERS AND SERVICES OUT-OF-NETWORK?

If Anthem is unwilling to agree to new contracts with CommonSpirit, 11 of our
Colorado hospitals, as well as our clinics, physicians and advance practice
providers in Colorado would no longer be in-network with Anthem beginning May 1,
2024.

What happens if no agreement is reached? Will I still be able to receive care
from CommonSpirit hospitals, clinics and advance practice providers?
Yes, patients will still be able to access care from our hospitals, clinics,
physicians and providers. However, Anthem will consider these services in
Colorado to be out-of-network, resulting in higher costs for patients.

WHAT HAPPENS IF NO AGREEMENT IS REACHED? WILL I STILL BE ABLE TO RECEIVE CARE
FROM COMMONSPIRIT HOSPITALS, CLINICS AND PROVIDERS?

Yes, patients will still be able to access care from our hospitals, clinics,
physicians and providers. However, Anthem will consider these services in
Colorado to be out-of-network, resulting in higher costs for patients.

WHICH HOSPITALS WOULD BE AFFECTED?

Without a new contract, 11 of CommonSpirit’s Colorado hospitals, as well as
dozens of clinics and practices, and hundreds of physicians and advanced
practice providers will no longer be in network for Anthem consumers as of May
1, 2024.

These include:

 * Longmont United Hospital
 * Mercy Hospital (Durango)
 * OrthoColorado Hospital (Lakewood)
 * Penrose Hospital (Colorado Springs)
 * St. Francis Hospital (Colorado Springs)
 * St. Francis-Interquest Hospital (Colorado Springs)
 * St. Anthony Hospital (Lakewood)
 * St. Anthony North Hospital (Westminster)
 * St. Anthony Summit Hospital (Frisco)
 * St. Mary-Corwin Hospital (Pueblo)
 * St. Thomas More Hospital (Cañon City)

St. Elizabeth Hospital in Fort Morgan is the only exception to the termination
with Anthem on May 1, 2024. Only the hospital would remain in network until at
least July 11, 2024 due to a separate contractual agreement.

All CommonSpirit physicians, APPs, and other locations in Colorado such as
urgent care centers – as well as our other hospitals in Colorado – would be out
of network for patients with Anthem insurance beginning May 1, 2024.

WHY ARE ANTHEM AND COMMONSPIRIT UNABLE TO AGREE ON A NEW CONTRACT?

Anthem is one of the most profitable insurance companies in the United States.
Unfortunately, Anthem has proposed significant reductions in reimbursement for
the care our physicians, providers and nurses deliver in Colorado. Anthem is
putting profits over patient access and choice, preventing us from agreeing to a
new, responsible contract.

Responsible agreements with insurance companies allow us to attract and retain
health care professionals, bring new services to the community, invest in new
technology and maintain our facilities.

WHAT IS COMMONSPIRIT DOING TO PROTECT PATIENTS?

We are doing everything we can to protect patient access to the doctors, nurses
and services they know and trust. Our goal is to reach a new agreement and to
avoid any disruptions for patients. We will continue working with Anthem in good
faith to reach a new agreement that protects patients’ access to essential
services.

I’M UNDERGOING ACTIVE TREATMENT FOR A MEDICAL CONDITION. WHAT HAPPENS TO MY CARE
IF ANTHEM REMOVES COMMONSPIRIT FROM ITS NETWORK?

If Anthem and CommonSpirit are unable to reach an agreement before May 1, 2024,
patients who are currently in active treatment or have appointments or
procedures scheduled after that date may qualify for protected in-network access
through Continuity of Care benefits.

Continuity of Care is intended to protect patients from having to change
providers or having care delayed or disrupted if an agreement between a health
plan and provider is terminated. This benefit is a state law, and Anthem, like
all licensed health plans, must abide by the requirements.

Health care conditions that may be covered by Continuity of Care include:

 * Prenatal/obstetrical care
 * Chemotherapy
 * Radiation therapy
 * Physical/occupational/speech therapy
 * Elective surgery
 * Ongoing treatment for an acute inpatient stay
 * Discharge planning after an acute inpatient stay, even if your previous
   health insurance carrier is still following your care
 * Dialysis
 * Home health care
 * Hospice care
 * Home IV therapy
 * Inpatient rehabilitation
 * Durable medical equipment
 * Supplies

You may save and fill out the Continuity of Care Request Form here.

Ask your doctor’s office if you need assistance with filling out the Continuity
of Care form. For questions about Continuity of Care eligibility, benefits, and
access to the form, please call Anthem using the number on the back of your
insurance card.

WHAT CAN PATIENTS DO TO PROTECT THEIR ACCESS TO CARE?

Patients can take action today to protect their health care access and choice:

 * Call Anthem at the number on the back of your insurance card and urge Anthem
   to work with CommonSpirit doctors and nurses on a new agreement.
 * If you have insurance through your employer, talk to your human resources or
   benefits representative and urge them to contact Anthem. You may also want to
   ask them about alternate or secondary coverage options that will protect your
   in-network access to CommonSpirit hospitals, clinics, physicians and
   providers.

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