December 03, 2020
Area(s) of Interest: Commercial Payors Payor Contracting
The Anthem Blue Cross High Performance/Blue High Performance Network (Blue HPN®) will become effective January 1, 2021. Blue HPN is part of a national network being created in collaboration with the Blue Cross Blue Shield Association. The new narrow network of physicians is a subset of the broader Anthem Prudent Buyer PPO network and will be utilized for its Exclusive Provider Organization (EPO) product line.
Blue HPN will be available in six metropolitan service areas located in the following Northern and Southern California areas:
- San Francisco-Oakland-Hayward
- San Jose-Sunnyvale-Santa Clara
- Los Angeles-Long Beach-Anaheim
- San Diego-Carlsbad
- Riverside-San Bernardino-Ontario
While specific criteria for physician participation in Blue HPN are unspecified, Anthem issued notices in early October automatically opting-in providers who have been selected to participate in Blue HPN. According to the notices, the terms of each physician’s underlying commercial PPO contract will apply to the new Blue HPN network. On or prior to January 1, 2021, provider directories will be updated to reflect providers participating in the new Blue HPN.
Blue HPN patients will be issued new ID cards reflecting Blue HPN in a suitcase on the front of the card, signifying access to Blue HPN providers. Similar to other EPO narrow network plans, services rendered by non-Blue HPN providers are limited to only urgent and emergent care.
Physicians who are unsure whether or not they will be part of Blue HPN or those who have general questions about the program can contact Anthem Contract Support at CAContractSupport@Anthem.com.