Patient First No Longer Accepting New Anthem Patients

Patient First in Manassas.

Patient First announced that starting Feb. 2 it would not accept any new Anthem Blue Cross/Blue Shield Patients at any of its Virginia locations, nor any patients enrolled in Anthem’s Medicaid/FAMIS program and HealthKeepers Plus.

This comes at a particularly bad time for the urgent and primary care provider as the company is in the process of opening multiple new locations in the Northern Virginia and D.C. Metro region.

The new coverage policy will affect new locations.

“ all of our centers in Virginia, including the new one in Gainesville,” Ian Sinkman, Vice President of Public Relations and Marketing for Patients First said. “The new locations will be subject to the same limitations. We participate in most other major insurance plans, including most other Medicaid plans.”

In a statement, the company said the reason for the change was that Anthem has reduced its reimbursement rates.

We estimate that each year Patient First saves Anthem and Anthem clients nearly $50 million from avoided Emergency Department (ED) visits alone, in addition to the savings resulting from reduced work absences. Despite this cost savings, Patient First has effectively seen a reduction in the reimbursement rates paid to us for the medical services we provide to Anthem policyholders.

Sinkman said cost of living increases are typical and “built into our agreement with insurance companies.” What is not typical are insurance companies denying the annual increases.

“Contracts typically have annual increases. Anthem is the only insurance provider that does not provide these increases," Sinkman said.

Patient First's website said the company believes it is only fair that as health care costs continue to rise, Patient First be reimbursed “at a rate that allows us to deliver care and compensation to our doctors and medical support staff.”

Prince William County Schools, the largest employer in the county, offers Anthem insurance as does Prince William County Government.

“We are committed to providing patients with resources and support during this transition," they said ."We remain hopeful that Anthem will work with us to resolve this situation before February 2, 2016, and in a way that does not impact our current or future patients.”