Column : Sentara

“When elephants fight the grass suffers,” says an old African proverb. So when Sentara Health and Anthem Blue Cross Blue Shield of Virginia, Hampton Roads’ two health care elephants, lock tusks in a battle to the death, we are that grass and it’s our wallets that will get trampled. Hampton Roads is one of the tightest health insurance markets in Virginia. On the individual Affordable Care Act marketplace, residents can choose between exactly two carriers: Anthem and Sentara. Their brawl is over Sentara‘s insistence that Anthem increase its payments by 6. 2% while Anthem, saying it wants to keep costs down for its policyholders, has asked for a 1% reduction. With no agreement in sight, Sentara has notified Anthem that most of its contracts with Anthem will expire at year’s end. When that happens, more than 200,000 Anthem-insured residents in Hampton Roads face being out of network, whether they go to Sentara’s doctors, to its hospitals for scheduled hip surgery, CT or MRI scans, or even to start cancer chemotherapy. For those types of non-emergency care, Anthem’s HealthKeepers HMO could deny their claim entirely, leaving them responsible for Sentara’s full chargemaster price. So a $400 bill for a CT brain scan at Sentara Leigh might balloon to Sentara’s “sticker price” of more than $2,500. In a July press release, Aubrey Layne, Sentara’s executive vice president, stated “our existing rates with Anthem already do not support what it takes to deliver care. ” He goes on to say that many hospitals across the nation are hard-pressed by higher costs, lower reimbursements and slashed federal supplements. But Sentara’s 2025 Financial Statement of Operations Report shows operating margins at its six Hampton Roads averaging more than 20%, earning those hospitals more than $1 billion in 2025.