Capitola Surgery Center Delivers Notice To Terminate Contracts With Anthem Blue Cross

By webmaster; February 18, 2020, 18:32 GMT+0000

MONTEREY, Calif., Feb. 18, 2020 /PRNewswire/ — After months of stalled good faith negotiations attempting to negotiate reasonable terms, Monterey Peninsula Surgery Center (MPSC) regrettably announced its intent to terminate its contract with Anthem Blue Cross (Anthem). The termination will take effect in 30 days, until which MPSC and Anthem may continue to negotiate. If MPSC and Anthem are unable to reach an agreement on new contract terms, the termination will become effective on or about March 18, 2020.

MPSC takes its decision seriously and believes that Anthem forced MPSC’s hand. MPSC commenced contract negotiations with Anthem in September 2019, offering modest rate increases to keep up with the cost of doing business in Monterey and Santa Cruz Counties. Even with the rate increases proposed by MPSC, MPSC would still be the lowest cost provider available to Anthem patients for nearly all procedures in local service areas. In fact, MPSC is the only provider offering certain surgical services in Monterey County.

Anthem refused to engage in meaningful discussions with MPSC, instead responding to MPSC’s proposal for modest rate increases with Anthem’s own proposal for a rate reduction. Anthem effectively sought to extract revenue from MPSC at the same time that it reported record 13% growth in revenues in 2019.

“It is imperative for MPSC to receive competitive rates to continue to offer access to timely and high quality surgical services to local residents”

David Awerbuck MD,
Chair of MPSC Board

Anthem’s proposal seeks to impose payment reductions on the only multi-specialty outpatient surgical center in Monterey. “It is imperative for MPSC to receive competitive rates to continue to offer access to timely and high quality surgical services to local residents,” said David Awerbuck MD, Chair of the MPSC Board. “Anthem’s actions negatively impact its members by forcing them to shoulder higher costs by limiting their choices or seeking out-of-network services at MPSC. This undermines the community’s interest in preserving affordable options available to patients.”

“Anthem is leveraging their large market share to force small independent providers such as MPSC to accept lower reimbursement rates. This is an unwise business strategy, as independent surgery centers, like MPSC, provide excellent surgical services at a lower cost. This short-sighted power play will result in significantly higher costs for both Anthem and their members,” stated Tom Wilson, CEO of MPSC.

MPSC will continue to serve Anthem patients with current appointments. If Anthem is unwilling to agree to reasonable terms by mid-March, MPSC will be available to Anthem enrollees who are already under the care of MPSC or on an out-of-network basis. MPSC will provide updates on the status of the negotiations and any change affecting the relationship between MPSC and Anthem.

More News