REGION — Patients with Anthem Blue Cross insurance can once again receive in-network care through Scripps Health until September 2026, after the two entities agreed to extend their contract last week.
The extension comes over five months after Anthem and Scripps failed to agree upon contract terms by the Jan. 1 deadline, leaving over 125,000 Anthem policyholders unable to access in-network care through San Diego County’s largest medical provider.
The lapsed contract left thousands scrambling to find new providers and reschedule appointments and procedures. Patients undergoing ongoing treatment for cancer and other conditions applied to receive a continuum of care, facing the possibility of having to start over their treatment with new doctors.
Negotiations continued after that, and while Scripps and Anthem have yet to finalize a contract, they announced that they have agreed to an interim extension retroactive to Jan. 1.
“After many months of negotiations, Scripps and Anthem Blue Cross have agreed to an extension of our current contracts. This means that while negotiations will continue on a sustainable, long-term agreement, patients with Anthem Blue Cross insurance will regain in-network access to their Scripps Health doctors and hospitals until September 30, 2026,” Scripps said in a May 6 statement.
Anthem said the new contract applies to all Scripps doctors, hospitals, outpatient centers, and affiliated care providers.
Stephanie Hebert of San Marcos said while she is pleased to see the contract extended, it has been a very frustrating experience for her and other patients. She and her family ended up switching their primary care providers, and will now have to switch back.
“Now I will have to change back to my original primary caregiver and make an appointment for my annual check up and labs. My family members will also have to do the same as we all had the same primary caregiver. A lot of paperwork shuffling for everyone and delayed appointments,” Hebert said.
Under the agreement, claims related to Scripps care from Jan. 1 onward will now be processed as in-network, Anthem officials confirmed. The company said patients can also contact Anthem to re-enroll with a Scripps doctor.
“We are pleased Scripps Health has rejoined our local network of care providers in San Diego and we look forward to continuing our partnership,” said Beth Andersen, President of Anthem Commercial Health Plans in California. “Our members and employer customers remained our number-one priority as we worked hard and in good faith to find common ground and reach agreement with Scripps.”
While affected patients figure out what to do next, Anthem and Scripps will be continuing to negotiate a final agreement. Scripps said they hope to complete this process before the extension ends in September.
Since the extension is only a temporary Band-Aid, many patients are still unsure how to proceed.
Susan Beeson of Carlsbad struggled to find new providers for her family after losing coverage at Scripps in January, and said she is frustrated that the two groups have not reached a final agreement yet.
“I’ve spent considerable time and stress in finding new healthcare providers for myself, my spouse, and my children. Do I continue these new relationships? Or do I go back to our Scripps providers, knowing that I may have to go through having them disappear overnight again in September 2026? It’s little solace to have this short extension. I wish these companies remember that we are people, not cost centers,” Beeson said.
Both Scripps and Anthem have pointed the finger at each other regarding failed negotiations. Scripps officials have said they want Anthem to remove the bureaucratic “red tape” that doctors and staff spend significant time and resources navigating, and Anthem has said Scripps would not accept the reimbursement rates they offered for medical providers.
This is not the first time Scripps patients have lost coverage. On New Year’s Day of 2024, around 32,000 San Diego County seniors were affected when two major Scripps medical groups, including Anthem Blue Cross and Blue Shield of California, ceased accepting Medicare Advantage plans from carriers.
Scripps has five main hospital campuses in San Diego, Chula Vista, La Jolla and Encinitas and dozens of clinics and urgent care sites, with specialty care in cancer, cardiology, orthopedics, gynecology and more.
The medical provider is also planning a new medical center in San Marcos.
