Anthem Blue Cross Members Regain Access to Scripps Health

After four months of the expired contract between Scripps Health and Anthem Blue Cross, which left about 125,000 residents in San Diego County needing to switch their health plans or find new physicians, the healthcare provider declared on Tuesday that they have reinstated their former agreement.

Scripps informed patients via email that individuals covered by Anthem Blue Cross can now start scheduling appointments again with their roughly 3,000 associated physicians and utilize Scripps' facilities of hospitals and clinics across the area.

During the autumn of 2024, Scripps informed their patients that they may choose not to renew the agreement with Anthem due to disagreements regarding payment amounts as well as because the healthcare provider found certain prerequisites for pre-approval of medical services billed to insurance overly demanding.

Richard Neale, who serves as the corporate executive vice president and Scripps' chief growth officer, stated on Tuesday that the recently signed deal with Anthem merely prolongs the conditions of the prior agreement until September 30, 2026.

Conflicts regarding compensation and previous medical authorization are still not resolved.

This is merely an extension, not a fresh contract," Neale stated. "In this extended term of a sustainable agreement...the main focuses will be addressing the obstacles preventing patients from receiving the recommended medical care by their doctors, as well as ensuring Scripps receives equitable compensation. These key areas will guide our negotiations throughout the extension phase.

Little information was available on just how many of the more than 125,000 local Anthem beneficiaries stayed with the carrier, hoping for a quick resolution and how many decided to choose a different carrier during the annual open enrollment period, which usually occurs in the fall.

Anthem did not disclose the number of individuals who switched carriers or the count of health management organization members transferred to alternative local healthcare providers after Scripps became unavailable starting January 1st.

We're delighted that Scripps Health has once again become part of our local network of healthcare providers in San Diego," stated Beth Andersen, President of Anthem Commercial Health Plans in California. "As we strived diligently and sincerely to align interests and come to an understanding with Scripps, ensuring satisfaction for both our members and business clients stayed at the forefront.

Many patients found comfort in the news on Tuesday.

Ron Stolberg from Rancho Penasquitos mentioned that he switched to Sharp HealthCare from Scripps, whereas his spouse did their best to remain within the Scripps system whenever feasible, even though certain tests required over the last four months were conducted at Sharp.

I believe this is wonderful news for people like me who cherish our history with Scripps," Stolberg stated. "However, many of us have formed new connections with healthcare providers outside their system. If this issue had been resolved earlier, it would've been better to avoid putting more than 100,000 patients under strain as they turned to alternative healthcare networks.

“It’s hard to know what to do now, be faithful to a new provider who took us in, or the one we know better but dismissed us over a contract dispute.”

While he said he is on the fence, he said his wife plans to return to Scripps as soon as possible.

Why not extend the contract last year rather than waiting for four months? Neale said that an extension was not on the table.

“We had actually recommended or proposed to Anthem at that time to extend the terms of the existing agreement to negotiate that long-term agreement,” Neale said. “At that time, they turned us down.”

Scripps did not seem to face significant financial setbacks due to the brief separation from Anthem. According to quarterly financial documents submitted to the state, revenue from third-party payers—primarily commercial health insurers—inched up marginally in early 2025 relative to early 2024. The organization corroborated this pattern via email on Tuesday.

Neale mentioned that individuals with preferred provider or exclusive provider organization insurance can get immediate access since they permit beneficiaries to freely refer themselves to any physician within their network. In contrast, people covered by a health maintenance organization have to go through Anthem for such services.

For EPO or PPO members, they should contact (Scripps) right away to schedule an appointment," Neale stated. "As for HMO members, they must reach out to Anthem to request a transfer to a Scripps provider.

The updated agreement doesn’t cover Anthem plans within the Covered California health insurance marketplace. Neale chose not to provide details on why these plans won't be reinstated with Scripps in their network. However, he mentioned that approximately 14,000 Scripps patients used Covered California Anthem plans as of late 2024. Some individuals might have changed their health insurers during the previous year’s fall and early winter open-enrollment period to continue having access to Scripps services.

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