Cleveland Clinic patients covered by Anthem Blue Cross and Blue Shield could lose in-network access to the health system on Jan. 1 if the two sides do not reach a new contract agreement. Cleveland Clinic and Anthem have been in negotiations for months over a new contract, and the Clinic is now notifying affected patients about the possibility that its Ohio facilities and providers would be out of network starting in the new year.
The change would affect people covered by Anthem employer-sponsored plans and Anthem Medicare Advantage plans. According to Anthem spokesperson Stephanie DuBois, more than 113,000 people on those plans have visited a Cleveland Clinic site at least once in the past 12 months. For those patients, a lapse in the contract would mean Cleveland Clinic care would no longer be covered as in-network care under their Anthem plans.
The deadline is Jan. 1, 2027, when the current two-year contract between Cleveland Clinic and Anthem ends. If no agreement is reached before that date, all Cleveland Clinic facilities and providers in Ohio would be out of network for the affected Anthem employer-sponsored and Medicare Advantage plans beginning Jan. 1.
Nothing changes before Jan. 1. Appointments scheduled before that date will continue normally, and patients do not need to change care they have planned for the remainder of this year because of the negotiations. Emergency care is also not affected, as emergency services are legally required to be covered. The possible change does not include Anthem Medicare Supplemental plans, Medicaid plans, or MyCare plans.
Both sides say they remain committed to talks. Cleveland Clinic and Anthem have each described themselves as optimistic and committed to negotiating in good faith, with a shared stated goal of protecting patients’ access to care. The notifications to patients are being sent while those negotiations continue, well ahead of the Jan. 1 deadline.
Cleveland Clinic is also seeking continuity-of-care coverage for some patients for a limited time if the contract ends, subject to approval by Anthem. That coverage, if approved, would allow certain patients to continue care for a limited period under specific circumstances. Angie Smith, the Clinic’s senior director of corporate communications, said patients were told about the situation now so they can make informed decisions about their care and coverage.
For now, affected patients are being advised by the timeline itself: care through the end of the year is unchanged, emergency care remains covered, and the outcome depends on whether a new agreement is reached before Jan. 1. Patients on Anthem employer-sponsored and Medicare Advantage plans who use Cleveland Clinic can watch for updates from both the Clinic and Anthem as negotiations continue and as decisions about coverage for next year are made.
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