A new policy by the health insurer Anthem will penalize hospitals for using doctors outside of its coverage network.

Anthem claims the move is designed to reduce its members’ out-of-pocket costs. But critics argue it will force medical facilities to police physicians’ network status, strong-arm doctors into accepting lower payments from health insurance companies, and could lead to fewer care options for patients.

According to the new policy, which will take effect on January 1, Anthem will cut a hospital’s reimbursements by 10 percent whenever the facility submits a claim that includes services from out-of-network providers. Additionally, hospitals that rely on out-of-network service providers will risk “potential termination from Anthem’s networks,” according to Anthem’s notice.

The policy will impact plans across eleven states, including Colorado, Georgia, and New Hampshire — all of which are managed by Elevance Health, a multibillion-dollar health company that operates Anthem Blue Cross and Blue Shield plans across fourteen states and serves millions of people.

In a policy update for New Hampshire facilities, Anthem states that in order to “support patient care, and to help reduce out-of-pocket expenses for our members, it is essential that members are directed to care providers participating in our Anthem network.”

A spokesperson for Elevance Health reiterated potential patient benefits in an email to the Lever.

“This policy will encourage fair contracting and reduce abuse, resulting in better affordability, quality, and enhanced protection for members from surprise medical bills,” she wrote.

However, medical professionals say this policy will force facilities to police whether their providers are in-network with Anthem — something that is “not only impractical but raises serious legal and ethical concerns,” according to a letter sent this month by three medical societies to Elevance Health’s CEO.

Consequently, hospitals and patients may be left scrambling for care.

“To avoid penalties and network termination, hospitals may feel forced to replace or reorganize physician groups, which disrupts continuity of care and creates gaps in coverage for essential services like anesthesia,” Patrick Giam, president of the American Society of Anesthesiologists, a medical association that serves more than 50,000 physicians and scientists, wrote in an email to the Lever. “This could lead to delays in procedures, longer wait times, or outright inability to provide certain services.”

For example, a hospital may contract with a single anesthesiology group to provide its anesthesia services. However, if Anthem’s out-of-network penalty policy is implemented and the anesthesia group refuses to join Anthem’s network due to unfavorable contract terms, the hospital may decide to switch anesthesiology providers, Giam explained.

“The transition of groups is never easy or smooth,” he wrote. “It is very disruptive to the hospital operations. Surgeries are delayed and even canceled until the new group can fully staff up.”

Patients covered by Anthem may also lose access to quality providers.

“A highly regarded anesthesiologist might be just fine — and available — to treat patients insured by Cigna or Aetna or Humana, but off limits to treat an Anthem-insured patient,” health insurance reform advocate Wendell Potter wrote in his newsletter, HEALTH CARE un-covered. “The hospital will have to be especially vigilant to keep that doctor out of the operating room when an Anthem patient needs surgery,” or else “get booted out of Anthem’s network.”