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Important Information for Patients with Anthem of Virginia Health Insurance

Open Letter to the Community - From Mark Nantz, President and CEO

"One month ago, Valley Health sent a letter to many community members providing an update on discussions with Anthem of Virginia over a new contract that would more fairly compensate our caregivers for services we provide to patients who have Anthem insurance. I want to emphasize that point: Valley Health’s negotiation with Anthem is about fairness.

We felt it was important to inform our patients who would be affected if Anthem continues to insist on unfair terms and Valley Health is not in their network after December 31, 2020, when our current agreement expires. Notifying these patients has raised some concern in the community, but we believe it was the ethically responsible thing to do. The deadlines for many patients and businesses to renew their coverage are fast approaching and it would be wrong for us to not speak up while our patients renew an insurance policy that may not include the local health system in their network. We are hearing from many employers that they have not reviewed their insurance plan in many years and, because of receiving our letter, are finding there are indeed less expensive choices with equal or better coverage.

This situation did not just start. We have spent months offering Anthem a solution that would preserve subscribers’ in-network access to Valley Health care and services, and more fairly compensate our organization for the care we provide. Anthem has not agreed to our solution, nor have they proposed a reasonable alternative. Anthem’s only reply has been to propose a cut in reimbursement rates, which already haven’t kept pace with inflation over the past four years and are significantly lower than what many other insurers pay. It is not reasonable to expect that Valley Health would agree to a decrease in payment when other insurance companies already pay their fair share of healthcare costs.

Anthem routinely raises its members’ premiums, and I am sure many assume they pass that increase on to local doctors and hospitals -- but that is not the case. As Anthem raises premiums, they do not increase payments to healthcare providers at a comparable rate. We are simply asking Anthem to invest more of the premiums patients pay directly into patient care instead of their own corporate profits. Anthem also claims that by more fairly compensating Valley Health, our rates will be the highest in the state. That simply isn’t true either.

Anthem’s unwillingness to work with Valley Health comes on the heels of record profits they have realized. The formula is simple: charge patients more and pay healthcare providers less. This is how Anthem’s stock value has quadrupled in the last 10 years. (Anthem is a for-profit, publicly traded organization).

In contrast, as a not-for-profit organization, Valley Health reinvests any excess revenue back into our community to keep medical technology current, facilities safe and up-to-date, care accessible and affordable to all, and provide over $20 million each year in healthcare to community members who are otherwise unable to afford services. Instead of paying dividends to investors like a for-profit company, Valley Health brings dozens of new physicians into the community each year and has invested hundreds of millions of dollars in new facilities and equipment over the past decade. I ask you to drive through any community in our region and take note of the many examples of how Valley Health is improving access to care and services. We strongly believe that Anthem should be investing more of the premiums patients pay each month into healthcare, not profits.

These circumstances are not easy to explain to our patients – especially those who have had Anthem coverage for many years. It is understandable that they might hope Valley Health will agree to whatever Anthem dictates, but offering reimbursement rates that don’t even keep up with inflation simply isn’t fair to Valley Health or the thousands of other patients in the region whose insurance does pay fairly when they use healthcare services.

I remain relentlessly focused on caring for the community and maintain an unwavering commitment to our 6,500 employees – the people who provide the community’s healthcare. To demonstrate that commitment to patients, Valley Health has offered Anthem a solution that would ensure patients continue to have the care they need. We are hopeful that Anthem will be a good partner to our caregivers and work with us to put patient needs first.

For more information about this issue, patients may call Valley Health at 1-866-414-4576."

Mark Nantz

President and CEO,

Valley Health System

Our Work With Anthem

As caregivers, nothing is more important to Valley Health than ensuring our friends and neighbors have access to the care they need.

For several months, our team has been working with Anthem of Virginia to achieve a new contract that would ensure patients continued in-network access to Valley Health caregivers and services, while also making sure our team can continue confronting the COVID-19 pandemic and other health challenges.

Unfortunately, Anthem has been unwilling to work with Valley Health caregivers. We are preparing for the possibility that Valley Health will no longer be in-network with Anthem beginning January 1, 2021. If this occurs, Anthem will consider all Valley Health caregivers and services out-of-network, and Anthem-insured patients could see higher costs.

Valley Health is a not-for-profit, locally-led health system committed to providing patients with high quality care close to home.

We are required to reinvest excess revenue back into enhanced patient services, new technology, safe, up-to-date facilities, and bring new caregivers to our community.

Recent mission-centered investments by Valley Health include:

  • Recruiting dozens of new physicians so patients don’t have to leave the area for specialty care or wait long periods to see a doctor;
  • Building a new replacement hospital in Warren County (the fourth community hospital Valley Health has constructed since) and making substantial renovations to improve access and capacity at other facilities;
  • Creating new Neuroscience and Orthopedic patient units in shell space of Winchester Medical Center’s North Tower to meet growing patient demands;
  • Purchasing new equipment for the Ambulatory Surgery and Cancer centers to achieve positive patient outcomes;
  • Acquiring state-of-the-art Da Vinci robotic surgery systems to offer surgeons greater precision, and patients faster healing and return to normal activity,
  • Opening accredited Urgent Care centers to provide convenient walk-in care for minor illness and injury;
  • Awarding community health impact grants totaling over $3 million to boost the efforts of nonprofit partners to improve health outcomes in our service area.

Fair agreements with insurance companies are essential for investments like these and for Valley Health to meet expanding and unforeseen patient needs. Additionally, these investments stand in contrast to the profits Anthem is passing on to its shareholders.

What You Need to Know

  • If Anthem continues to be unwilling to work with Valley Health, our caregivers and services will be out-of-network with Anthem beginning January 1, 2021. This means Anthem-insured patients could see higher costs for the care Valley Health caregivers provide.
  • Valley Health is committed to finding a solution that will protect patients. We are focused on ensuring our ability to continue confronting the COVID-19 pandemic and other health challenges and we have offered Anthem a solution to accomplish this goal.
  • Valley Health has long-term contract agreements with all other major insurance companies. Please know we are working with Anthem in good faith to protect your access to care.
  • Our valued patients need to know that nothing will change before January 1, 2021. Patients should keep the appointments they have scheduled with their caregivers.

Protect Your Access to Valley Health

Please visit this page to learn what you can do to protect your access to Valley Health.

View Answers to Frequently Asked Questions

Please visit this page for FAQs.

To speak with a Valley Health representative, please email financial.counselor@valleyhealthlink.com or call 1-866-414-4576.