The dispute could affect nearly 380,000 Anthem members in Virginia. Dive Insight:The dispute follows more than eight months of negotiations between the Virginia health system and the insurer. Sentara could go out of network for approximately 43,000 Anthem members on Jan. 1, according to a Sentara spokesperson. According to Sentara, the system sought a 6.2% annual reimbursement increase across the affected contracts with Anthem, while the insurer proposed reducing rates by approximately 1%. The pay cut would deepen an already existing reimbursement gap that fails to cover the cost of delivering care, the health system said.