Thousands of Anthem customers may lose access to CHOMP by February.

A statewide initiative to lower hospital costs is now playing a role in a conflict between the Community Hospital of the Monterey Peninsula and Anthem Blue Cross. The insurance company announced on Dec. 22 that customers on commercial and employer-sponsored plans by Anthem will lose network access to CHOMP by Feb. 1, if an agreement cannot be reached with parent company Montage Health by the end of the current contract on Jan. 31.

According to a statement by an Anthem spokesperson, company officials are “asking CHOMP to work with us to improve affordability and align future cost growth with statewide benchmarks,” referring to spending caps imposed by the California Office of Health Care Affordability board. CHOMP and six other high-cost hospitals are required to limit spending growth to 1.8 percent in 2026, compared to 3.5 percent by lower-cost facilities.

In response, Montage Director of Marketing and Communications Mindy Maschmeyer said that Montage is committed to, and working toward, complying with the spending cap.

“Despite these efforts, Anthem is using OHCA as a justification to impose [reimbursement] rates that fall below medical inflation,” she said. “Anthem’s threat to terminate our agreement jeopardizes access to essential health care services for thousands of families on the Monterey Peninsula.”

The action would not impact Medicare patients, the Anthem spokesperson confirms. Anthem members would still have access to Montage providers outside of the hospital – only CHOMP would be out-of-network. Exceptions may be available for ongoing care or procedures already scheduled.

In the past two years, Anthem members with Salinas Valley Health and Aspire have each experienced separate disruptions in coverage when contract negotiations faltered between Anthem and the organizations. In both cases, contracts were eventually agreed to and coverage was restored.