It impacts the ability of members of Blue Shield’s commercial HMO and PPO plans, as well as Covered California PPO members, to access Community Medical Centers’ four hospitals and nearly 500 providers in Community Health Partners.

This contract expiration does not affect Community Health System employees.

Community Health System requires fair, sustainable agreements that reflect the cost of delivering high-quality care. Our health system is challenged with persistent increases in drugs, supplies and other costs, and the unfavorable, yet still uncertain, impact of the latest federal reconciliation bill.

Community is asking Blue Shield for parity. Blue Shield’s rates must cover the cost of care akin to what our other contracted providers pay. This helps ensure financial stability for Community and creates a level playing field in the market. Without parity, Blue Shield has an advantage over other health plans and that will serve to widen the gap between the cost of providing care and what we are reimbursed for it — ultimately leading to reductions in services available in our region.

Yes, Community participates in health plan quality performance programs because ensuring and monitoring quality outcomes for our patients is essential. We participate because it’s a key way providers and plans can work together to improve overall quality of care. Currently, we participate in quality programs with Aetna, Anthem and HealthNet.

However, it’s important to understand this isn’t a solution to close the gap between cost of care and reimbursement. Health plans may try to cloak inadequate reimbursement  in performance incentive frameworks that emphasize improved patient outcomes, then publicly criticize providers when we find this unacceptable.