RICHMOND, Va. (WRIC) — As of Aug. 1, a trip to the doctor’s office could cost about 19,000 Virginians — 13,000 of whom are based in Richmond — more money.

The healthcare system, Bon Secours, and the insurance company, Anthem Blue Cross Blue Shield, were unable to re-negotiate a Medicare Advantage Contract in time to prevent contract termination.

It’s been a looming threat that if the two parties don’t reach an agreement by Aug. 1, Bon Secours providers and facilities would become “out-of-network” for Anthem Medicare Advantage patients.

The healthcare entities initially reached an agreement back in 2022 — signing a three-year agreement. However, things became complicated recently when Bon Secours approached Anthem halfway through that contract, rather than near its end, to re-negotiate. Bon Secours hoped to increase commercial rates in response to factors like inflation and on-going supply chain issues.

A spokesperson for Bon Secours, Emma Swann, answered questions regarding the catalyst for this proposed change.

“What Anthem pays our doctors, nurses and other caregivers is not sustainable or market competitive,” Swann explained.

Swann also cited a 9.6% labor cost increase and a 6.8% operating expense increase in recent years that the system needed to keep up with in order to continue to provide patients with care at the caliber of which the system operates.

While Bon Secours called their request modest, Anthem claimed it was three times the current hospital inflation rate. The insurance providers also called this contract termination rare. They said that the most vulnerable are the ones being impacted.

So, in the meantime, patients with special circumstances — like pregnancy or cancer — are encouraged to apply for “continuity of care.” Through this process, Anthem will evaluate different circumstances on a case-by-case basis to determine whether specific patients qualify to maintain current rates and providers regardless of network status.

Amid this conflict, all Bon Secours patients will continue to have access to Bon Secours Emergency Departments at no higher out-of-pocket cost.

The two healthcare entities are continuing negotiations — and re-negotiations — for remaining contracts, including Medicaid. If an agreement isn’t reached by the end of September, Bon Secours could also come to be considered “out-of-network” for Anthem Medicaid patients.