‘Slap in the Face’: Some Community Health Workers Uninsured Due to Health Plan Negotiations

FRESNO, Calif. (KFSN) — More than two weeks have passed since then Contracts have expired Between community health systems and different health plans. The negotiations have stalled.

Community Health is out-of-network for Anthem Blue, Cigna and UnitedHealthcare members. It affects hundreds of thousands of Fresno County residents, community patients and health care workers.

“The irony is that we’re working downtown and we’re working in Clovis and other hospitals, and we don’t have access to our own private practice at those hospitals,” said Dr. Amy Evans.

A pediatrician works at Clovis Community Medical Center and Community Regional Medical Center.

She is still covered by one of the plans under negotiation, and has spent the past few weeks trying to figure out what her options are if she needs any preventative care.

“I think it’s really a slap in the face for doctors who work in hospitals not to be able to go to where we work,” Dr. Evans said.

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

“I wouldn’t go there if I had acute appendicitis,” she said. “Fifty miles away, give me a break.”

According to the community websitePatients may request “continuity of care” with their same provider but under certain circumstances.

Dr. Evans hopes the dispute will be resolved soon, and not only because she is affected, but so are many of her patients.

“I want people to grow up and come to the table and work with each other,” she said.

Action News reporter Amanda Aguilar reached out to Community Health for comment, but has not yet heard back.

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