Contract Negotiations Remain Unsuccessful Between Community Medical, Health Insurance Plans

Contract negotiations between health insurance companies and the municipality remain unsuccessful

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Thousands of Valley residents are uncertain about the future of their health insurance. The contracts between the public health system and the three health insurance companies have expired.

Laura Schott understands the importance of precaution.

"A routine visit found a small lump in my bladder - unexpected, unexpected for my age," she said. "I quickly went into surgery and got rid of it."

Despite being just a few years older than the recommended age for a mammogram, she's still getting a referral - scheduled for next week at Clovis Community Medical Center.

However, it turns out that scanning can be expensive.

"If you receive services from a non-contracted provider, the visit is not covered and is your financial responsibility," United HealthCare wrote to Schott in a Jan. 5, 2023 email.

She is one of thousands of United Health Care members who received a letter in late December saying the insurance company's agreement with the Community Health System expires on December 31, 2022.

According to the health system's website, the system is still in talks with United, Anthem Blue and Cigna.

This leaves health insurance members like Schott uncertain about their healthcare services.

United suggested other hospitals on the network, Schott said.

One of these was the Madeira Community Hospital, which is now closed. Also on the list are Valley Children's Health, St. Agnes Medical Center and Adventist Health in Ridley, Selma and Hanford.

The only viable alternative for Scott is St. Agnes, but she still has reservations.

"I don't know what it's going to be like for them as everyone is trying to do what I'm doing," she said.

Schott plans to book a mammogram in hopes health plans reach an agreement with Community Health.

On its website, the health system said, "We must call on health plans to recognize the unprecedented cost challenges of caring for Central Valley residents and work with us to reach fair and reasonable agreements."

United HealthCare sent a statement to Action News stating, "Current unreasonable demands on community health centers will result in a significant increase in healthcare costs for residents and employers in the Fresno area."

Anthem reiterated this statement: "Businesses and families in our state are already suffering from rising inflation, so we cannot accommodate calls for significant cost increases."

Schott felt trapped after seeing her doctor in the Clovis community and even upstate.

"He feels so helpless," she said.

Schott remains unhappy that she's paying for health insurance, which she says is now useless.

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