A contract dispute between Sentara and Anthem Blue Cross Blue Shield could impact thousands of people across Hampton Roads.
Sentara executives said if a new agreement isn't reached before the current contract expires on December 31, 2026, Anthem members could face higher out-of-pocket costs or lose in-network access to Sentara providers.
Sentara said it proposed a 6.2% blended rate increase for 2027, while Anthem countered with a 1% rate decrease.
About 215,000 Anthem members in Hampton Roads could be affected if the two sides can't reach a deal. Sentara said it remains committed to reaching an agreement before the end-of-year deadline.
Aubrey Layne, executive vice president and chief administrative officer of Sentara Health , addressed the length of the negotiations.
"Our team has been dealing with these negotiations for almost eight months, and we have been unable to get Anthem to agree to anything close to rates that will allow us to support delivering the care at Hampton Roads and across the state that we've enjoyed over the last few years."
Layne also raised concerns about unpaid claims.
"I wish this were just about just financial, but there are some other actions that that Anthem has taken to try to get us to negotiate to their way. One is they have more than $105 million in charges for unpaid claims that are more than 90 days overdue, so they have slowed their payments to us."
Anthem Blue Cross and Blue Shield released a statement on the negotiations:
"Anthem Blue Cross and Blue Shield and Sentara are currently negotiating to reach a new agreement before our existing contract expires on December 31, 2026. At this time, there are no changes to member coverage or access to care. Sentara hospitals, physicians, and facilities remain in our network, and members should continue to access care as they normally would. We remain committed to reaching an agreement and are actively negotiating in good faith to avoid any disruption for the members and communities we jointly serve. While we are disappointed that Sentara chose to make these negotiations public before they are complete, our focus remains on reaching an agreement at the negotiating table. Anthem has a responsibility to negotiate on behalf of the members, employers, and taxpayers we serve to help ensure we provide access to high quality and affordable care for members. These negotiations should not burden the patients and communities we jointly serve, and we remain optimistic we can reach an agreement before the current contract expires."
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