Doctors at Community Health can't get care at facilities due to stalled health plan negotiations

Amanda Aguilar Image
Wednesday, January 18, 2023
'A slap in the face': Some Community Health staff uninsured due to stalled health plan negotiations
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It's been more than two weeks since contracts expired between Community Health System and several health plans. Negotiations remain stalled.

FRESNO, Calif. (KFSN) -- It's been more than two weeks since contracts expired between Community Health System and several health plans. Negotiations remain stalled.

Community Health is out-of-network for Anthem Blue, Cigna and United Healthcare members. It impacts hundreds of thousands of Fresno County residents who are Community patients and healthcare staff.

"What's ironic is that we are working downtown and working at Clovis and other hospitals, and we actually don't have access to get our own personal medical care at those hospitals," said Dr. Amy Evans.

The pediatrician has privileges to work at Clovis Community Medical Center and Community Regional Medical Center but is not employed by Community Health System.

She's insured with one of the plans still in negotiations, and has spent the last few weeks figuring out what her options are if she needs any preventative care.

"I think it's a slap in the face to the doctors who actually work in the hospitals to not be able to go to the places where we work," Dr. Evans said.

Health plans are directing members to in-network facilities, such as Saint Agnes Medical Center or Adventist Heath in the South Valley.

"I'm not going to go there if I have acute appendicitis," she said. "Fifty miles away, give me a break."

According to Community's website, patients can request a "continuity of care" under their same provider but only under certain conditions.

Dr. Evans hopes negotiations get resolved soon, and not just because she's impacted, but so many of her patients are too.

"I would just like people to be big and come to the table and work with each other," she said.

Action News reporter Amanda Aguilar reached out to Community Health for comment specific to Dr. Evan's claims. We were referred to their website.