Anthem's New Policy Threatens Anesthesiology Practice Stability

Anthem Blue Cross Blue Shield has announced a new payment policy that will take effect January 1, 2026, in several states including Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, and Wisconsin. Under this policy, Anthem will reduce facility payments by 10% if any services are rendered by out-of-network providers. While the penalty is aimed at hospitals, it poses significant indirect consequences for anesthesiology practices and other hospital-based physicians whose services are bill separately but are closely tied to facility operations.  ASA has discussed this issue with representatives of the American Hospital Association and is actively exploring all available options to address this policy.

ASA is alarmed about the potential impact on physician autonomy, practice viability, and patient access to care.  The policy may pressure hospitals to require anesthesiology groups to join Anthem’s network, regardless of whether the contracted payment terms are fair or sustainable. Independent practices could face diminished negotiating power and be forced to accept lower payment rates to help hospitals avoid the 10% penalty.