FRESNO, Calif. (KFSN) — Action News has obtained a letter that went out to Fresno City employees; it notified them that starting this month, they will be without in-network care at various Community Medical Center locations. Now employees are calling for answers.<\/p>\n
More than 10,000 workers were notified that their healthcare contract was terminated as of February 1st, this due to ongoing contract negotiations between Community Medical Center and Blue Shield of California.<\/p>\n
“The city employees are frankly stuck in the middle and as a result of the contract expiring, these city employees are going to be forced to pay out of network premiums, which is going to cost them more money,” says Georgeanne White, Fresno City Manager.<\/p>\n
The Community Health providers normally offered to the ensured employees are now no longer available in the network.<\/p>\n
Those who are regularly seen at Community Regional or Clovis Community, now must find care elsewhere, like St. Agnes or Valley Children’s.<\/p>\n
In a statement to Action News, Blue Shield claimed CMC, “request(ed) to terminate the existing contract, with intent to renegotiate.”<\/p>\n
But CMC’s statement accused Blue Shield of, “electing not to grant another extension and let it expire January 31, 2026.”<\/p>\n
Blue Shield went on to say, “We have provided CMC a series of offers withfair and reasonable rate increases while protecting our members’ access to care. This includes offering additional payments when they deliverhigh-quality and good healthcareoutcomes for our members. CMC is not willing to tie any portion of their pay increases to performance, which is not in the best interest of our members.”<\/p>\n
CMC says they’re actively working with Blue Shield to “reach an equitable agreement as soon as possible so we can continue providing quality healthcare to those who rely on us.”<\/p>\n
“It’s unfortunate when you have somebody like Blue Shield and then a hospital system who are trying to come to resolution and each want something more from the others this can happen obviously, we’re not happy about it,” says White.<\/p>\n
This comes on the heels of Community Health System reaching an agreement with Aetna, restoring coverage for over 6,000 retirees from the Fresno Unified School District.<\/p>\n
Sharon Hart, worked as a teacher and administrator for over 20 years, she was among the former educators she says were put in a crisis situation.<\/p>\n
“It was really shocking in many ways. It just shows how broken our healthcare system is nationally. This is not a problem unique to Fresno or to Fresno unified retirees,” says Hart.<\/p>\n
Community health system is the fifth largest healthcare system in the state, their footprint critical in the Valley.<\/p>\n
We asked CMC about its bottom line, and if cuts to the federal government have impacted these negotiations.<\/p>\n
They responded saying, “Our ability to provide high-quality, accessible care for our patients depends on contracts that fairly reimburse our care teams for the services they deliver. We look at each contract individually, however stagnant and declining government payments obviously impact our overall financial picture leaving us no wiggle room to accept a contract that doesn’t adequately cover the cost of providing care,” says Aldo De La Torre, Division President, Insurance Services & Managed Care for Community Health System.<\/p>\n
The City of Fresno says its health and welfare board will hold a special meeting in March if the two parties do not come to an agreement by then to try and find alternate solutions.<\/p>\n
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