Tag Archives: Sutter Health

Sutter Health|Aetna adds Stanford Health Care to network

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , • Leave a comment

https://www.healthcarefinancenews.com/news/sutter-healthaetna-adds-stanford-health-care-network?mkt_tok=eyJpIjoiWldGbU16WmxOak00TmprMiIsInQiOiIzeGkycUpwcmtPUk42Z2R0b1k4RHd0NUVoY0k3UmE5TktUSkhMUzVtNVVWOWtWY3BhWkdUbjcrZndNS0tZRnA1cWFSajhWdmlZcUc4VE5DbFB4VEZNNkJyYTkyXC9XK3hxZVMwVzhSaVF2ZjZIdUFjbzZwcnF6aGE0UmowZ2w1eHcifQ%3D%3D

Image result for healthcare market consolidation

The joint venture between provider and payer, which launched last year, has grown to about 50 plan sponsors across 15 counties.

Sutter Health|Aetna has added Stanford Health Care to its network of providers.

Sutter Health|Aetna is the joint venture launched last year between the Sacramento, California-based health system and the national insurer. It offers self-insured preferred provider organization health plans to businesses in the Northern California area.

It has grown to about 50 plan sponsors across 15 counties.

WHY THIS MATTERS

This represents another expanded partnership between a provider and payer, though this is in the commercial space.

Other recent partnerships, such as the one announced between Duke Health and Blue Cross Blue Shield of North Carolina, have capitalized on the Medicare Advantage market.

Stanford Health Care recently launched a Medicare Advantage plan with Lumeris called the Stanford Health Care Advantage, in northern California.

The partnerships allow providers and insurers to expand their reach and get access to population health data to lower costs and improve outcomes.
The addition of Stanford Health Care gives Sutter Health|Aetna’s network members in Northern California access to the network’s more than 1,500 specialists and nearly 200 primary care physicians throughout the San Francisco Bay Area.

THE TREND

With the addition of Stanford Health Care, the Sutter Health|Aetna joint venture features two nationally recognized healthcare systems and access to a Northern California network that includes 33 hospitals, more than 1,700 primary care physicians, more than 9,400 specialists, 74 urgent care locations and 25 walk-in clinics.

ON THE RECORD

“The inclusion of Stanford Health Care, with its physicians from across Stanford Medicine, to our high-quality network will not only expand the provider network for our plan sponsors and members, but also provide access to another highly ranked health care system,” said Steve Wigginton, CEO of Sutter Health|Aetna. “This addition will help us in our goal to create a unique offering for Northern California employers and their employees centered around a superior consumer experience and market-leading value.”

 

 

Financial updates for Cleveland Clinic, Sutter + 9 other health systems

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/finance/financial-updates-for-cleveland-clinic-sutter-9-other-health-systems.html

Image result for dollars

The following 11 health systems recently released financial updates:

1. Naples, Fla.-based NCH Healthcare System saw its revenue and net income improve in the 2018 fiscal year. The health system ended fiscal 2018 with net income of $37.3 million, up 45.3 percent from $20.4 million reported in the year prior.

2. Salt Lake City-based Intermountain Healthcare saw its revenues and operating income improve in fiscal year 2018. After incorporating nonoperating income, which was $240.2 million lower than the year before, Intermountain ended fiscal 2018 with net income of $598.5 million. That’s down 8.6 percent from $655.1 million reported in fiscal 2017.

3. Boston-based Dana-Farber Cancer Institute‘s revenue climbed 11.5 percent year over year to $487.2 million in the first quarter of fiscal year 2019. After factoring in a $31.6 million investment loss, Dana-Farber recorded a net loss of $1.2 million in the first three months of fiscal 2019. That’s compared to the first quarter of fiscal 2018, when the hospital recorded net income of $46.1 million.

4. Bronx, N.Y.-based Montefiore Medical Center saw operating revenue increase in 2018 but ended the period with a lower overall operating margin. After factoring in nonoperating gains and losses, the medical center recorded net income of $26.6 million for 2018, down 52.9 percent year over year from net income of $56.5 million.

5. Renton, Wash.-based Providence St. Joseph Health saw operating revenue increase in fiscal year 2018 but ended the period with a net loss. After factoring in investment losses, Providence St. Joseph ended 2018 with a net loss of $445 million compared to net income of $780 million the year prior.

6. Cleveland Clinic‘s revenue increased in 2018, but the system’s operating income and net income declined year over year. After factoring in nonoperating losses, Cleveland Clinic ended 2018 with net income of $103.9 million, down 91 percent from $1.2 billion in the year prior.

7. Trinity Health recorded higher revenue in the first half of fiscal year 2019 than in the same period of the year prior, but the Livonia, Mich.-based health system ended the first two quarters of the current fiscal year with a net loss. After factoring in nonoperating losses of $419.6 million, including investment losses due to turbulent financial markets, Trinity reported a net loss of $301.5 million in the first half of fiscal 2019. That’s compared to the first six months of fiscal 2018, when the system posted net income of $806.4 million.

8. Quorum Health‘s revenue declined year over year in the fourth quarter of 2018, and the Brentwood, Tenn.-based company ended last year with a net loss. After factoring in expenses and one-time charges, Quorum ended the fourth quarter of 2018 with a net loss of $20.7 million, compared to a loss of $26.8 million in the same period of the year prior. Looking at full-year results, Quorum’s net loss widened from $114.2 million in 2017 to $200.2 million in 2018.

9. Sacramento, Calif.-based Sutter Health reported its first annual loss in 23 years due to investment losses caused by turbulent financial markets in the fourth quarter of 2018 and recognizing less revenue from the California Hospital Fee Program. Sutter reported a net loss of $198 million in 2018, compared to net income of $893 million in the year prior.

10. Columbia, Md.-based MedStar Health saw its revenue increase in the first half of fiscal year 2019, but ended the six-month period with a net loss due to the investment markets’ unfavorable performance. After including nonoperating results, MedStar ended the first half of fiscal 2019 with an $87.5 million net loss, compared to net income of $171.5 million in the first half of the prior year.

11. Philadelphia-based Temple University Health System saw its financial position improve in the six months ended Dec. 31. TUHS ended the six-month period with an operating loss of $26.2 million, compared to an operating loss of $39.1 million in the six months ended Dec. 31, 2017.

 

When Hospitals Merge to Save Money, Patients Often Pay More

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , , , , , , , , • Leave a comment
Image result for hospital mergers

The nation’s hospitals have been merging at a rapid pace for a decade, forming powerful organizations that influence nearly every health care decision consumers make.

The hospitals have argued that consolidation benefits consumers with cheaper prices from coordinated services and other savings.

But an analysis conducted for The New York Times shows the opposite to be true in many cases. The mergers have essentially banished competition and raised prices for hospital admissions in most cases, according to an examination of 25 metropolitan areas with the highest rate of consolidation from 2010 through 2013, a peak period for mergers.

The analysis showed that the price of an average hospital stay soared, with prices in most areas going up between 11 percent and 54 percent in the years afterward, according to researchers from the Nicholas C. Petris Center at the University of California, Berkeley.

During the Obama years, the mergers received nearly universal approval from antitrust agencies, with the Federal Trade Commission moving to block only a small fraction of deals. State officials generally looked the other way.

President Trump issued an executive order last year calling for more competition, saying his administration would focus on “limiting excessive consolidation throughout the health care system.” In September, Congress asked the Medicare advisory board to study the trend.

But not only have big consolidations continued, the behemoths have further cemented their reach in some regions of the country by gobbling up major doctors’ and surgeons’ practices.

“You have to watch for these systems throwing their weight around,” said Xavier Becerra, the California attorney general whose office has sued Sutter Health, a sprawling system in the northern part of the state. “We are looking for cases where consolidation does nothing for efficiency and leads to distortions of the market.”

Ted Doolittle, who heads Connecticut’s Office of the Healthcare Advocate, has fielded angry complaints from residents, but he sees few options available to officials. “A lot of this is too little and too late,” he said.

The latest giant hospital consolidations continue to stir concerns. Dignity Health and Catholic Health Initiatives, two large chains, are expected to become one of the nation’s largest groups — with 139 hospitals in 28 states — by the end of the year. And two of Texas’ biggest systems, Baylor Scott & White Health and Memorial Hermann Health System, recently announced plans to combine.

The New Haven area has witnessed the most significant decline in competition. Yale New Haven Health, one of the largest hospital groups in Connecticut, took over the only competing hospital in the city and has also aggressively expanded along the state’s coast. The group recently added another hospital to its collection, merging Milford with its Bridgeport location.

Although the price of a hospital admission in the New Haven-Milford area was already three times higher than in other parts of the state, prices surged by 25 percent from 2012 to 2014, compared with 7 percent elsewhere in the state, according to the Petris Center.

In the national analysis, a third of the metropolitan areas experienced increases in the cost of hospital stays of at least 25 percent from 2012 to 2014, from roughly $12,000 to at least $15,000.

Prices rise even more steeply when these large hospital systems buy doctors’ groups, according to Richard Scheffler, director of the Petris Center.

Thousands of Connecticut residents were stranded without a local hospital last year when another big hospital group, Hartford HealthCare, battled the state’s biggest health insurer over how much it would charge for patient care.

Its six hospitals are clustered around the state capital and are the only resort for residents in broad swaths of the eastern part of the state. This month, it announced plans to add a seventh hospital to its network.

“These systems are empire-building, there’s no question,” said Jill Zorn, a senior policy officer for the Universal Health Care Foundation of Connecticut, which seeks to improve access for residents. “But to whose benefit?”

Numerous studies by economists and others have underscored how hospital consolidation is driving up the cost of medical care. “Within the academic community, there is near unanimity,” said Zack Cooper, a health economist at Yale University who is among a group of researchers that has looked at how dominant hospitals affect prices.

The emergence of a one-hospital town is inevitable in many places, and the Parkersburg, W.Va., area is no exception. St. Joseph’s merged with neighboring Camden-Clark Memorial in 2011, and then they were consumed by what is now the state’s largest health system.

Residents can get most care locally but they go to Morgantown, where the academic medical center is situated, for complex conditions. “We’ve elevated the level of care,” Mr. Wright said.

But private insurers are paying more. In the Parkersburg-Vienna area, the overall price of a hospital stay increased 54 percent from 2012 to 2014, after the mergers. That is compared with 10 percent elsewhere in the state, according to the Petris Center.

Large systems “get paid better by some of the insurers,” Mr. Wright said.

Flailing hospitals often have little choice but to be acquired or go out of business, and a larger system can offer badly needed capital and management skills. “They can fix a hospital and benefit the community,” said Torrey McClary, a lawyer who specializes in mergers at King & Spalding.

When Yale New Haven Health took over the Hospital of Saint Raphael, a Catholic hospital six blocks away from its New Haven location, Saint Raphael was in danger of going under. Over the last six years, the system has invested more than $200 million in capital improvements at Saint Raphael, said its president Richard D’Aquila, including modernizing “everything behind the walls.”

Because it converted Saint Raphael into what is essentially a second 555-bed campus for its academic medical center, Yale New Haven Health defends the higher rates it charges private insurers as appropriate for a top-tier medical institution. Its community hospitals negotiate prices individually with insurers.

Systems also say they are trying to improve the care for smaller communities. “We’re actively trying to move care toward places that are accessible,” Hartford’s chief executive, Elliot Joseph, said.

But patients rarely reap the rewards of lower insurance premiums or out-of-pocket expenses when mergers occur.

Hartford executives talk about reducing the total cost of care in the same breath that they discuss the need to charge insurers more. “The math for us is how we move the care out of the hospitals while maintaining our financial stability,” Mr. Joseph said.

To defend higher rates, many hospitals cite low reimbursements from government sources, particularly Medicaid, and highlight their role as a safety net. “We’re left with no choice,” Mr. D’Aquila said.

Others, like Hartford, negotiate prices as a single entity, forcing health insurers to include all of their hospitals in a network or risk losing access in areas where there are no alternatives.

Hartford “has taken over so many hospitals and practices that, with the Anthem dispute, we felt we had no choices at all,” Sharry Goldman, a Storrs, Conn., resident, told state lawmakers. Although Hartford and Anthem Blue Cross, the insurer, eventually reached an agreement, Connecticut passed a law this year requiring hospitals and insurers to extend previous contracts for two months to protect consumers when the parties are at an impasse.

While patients may pay more for a well-known brand, like Yale, it is not clear that the higher price tags lead to better care, said Francois de Brantes, a health care executive who once worked at General Electric, which is headquartered in the state.

Since the merger, Yale New Haven has defended the higher rates it charges private insurers as appropriate for a top-tier medical institution.CreditChristopher Capozziello for The New York Times

“We have more lower-rated hospitals in Connecticut than in other New England states,” he said, pointing to an analysis he did at the time of the Anthem-Hartford dispute.

In the Albany, Ga., area, where the Berkeley researchers found a rare decline in hospital prices, the Federal Trade Commission had unsuccessfully attempted to block HCA, the for-profit hospital chain, from selling its hospital to its only local competitor in 2011. But the merger took place, and the F.T.C. reached a settlement with the parties involved.

While Berkeley researchers found area prices dropped, another study by two former F.T.C. employees, Christopher Garmon and Laura Kmitch, found that certain hospital quality measures declined. The merger “highlights the problems that can occur when competition is reduced,” the authors said.

The hospital group, Phoebe Putney Health System, dismissed the findings. “Phoebe has made great strides in enhancing the quality of health care available to the people of southwest Georgia,” Dawn Benson, Phoebe’s general counsel, said in a statement.

To foster competition, Lee County is planning a new 60-bed hospital within the Albany area.

In some cases, state regulators have opposed actions they consider illegal and anti-competitive. In Washington, state officials accused CHI Franciscan Health, based in Tacoma, of using its ties to two doctors’ practices to raise prices and decrease competition on the Kitsap Peninsula, according to a lawsuit filed last year.

The regulators argue that CHI wanted to wield its newfound clout by shifting some operations and imaging from less expensive outpatient settings to hospitals where they could charge more.

“I am all for taking advantage of hospital-based pricing, if we think it is doable in the market and the market can support it,” a CHI executive is quoted as saying in the lawsuit. “It would be great to drop a couple of million more to our bottom line.”

CHI Franciscan said the attorney general’s allegations were “misguided and unfounded.”

In California, Mr. Becerra, the state attorney general, brought a lawsuit against Sutter in March, claiming that its actions led to significantly higher prices in Northern California.

Sutter says it adopted methods encouraged by the federal health care law, by combining hospital services with care delivered outside the hospital to better meet patients’ needs.

But Mr. de Brantes, the health care executive in Connecticut, and others wonder why many mergers were allowed in the first place. “The puzzling part for many of us in the state is why anyone would allow these oligopolies to form,” he said.

 

 

 

Sutter’s operating income surges 806% in first half of 2018

Posted on by • Posted in Uncategorized • Tagged , , , • Leave a comment

https://www.beckershospitalreview.com/finance/sutter-s-operating-income-surges-806-in-first-half-of-2018.html

Related image

Sacramento, Calif.-based Sutter Health saw revenues and operating income increase in the six months ended June 30, according to recently released unaudited financial documents.

Here are four things to know:

1. The health system reported operating revenues of $6.3 billion in the first six months of 2018, up 6.5 percent from revenues of $5.9 billion in the same period a year earlier. Sutter said the increase was primarily attributable to higher patient service revenues and premium revenues, which climbed 5.3 percent and 11.3 percent year over year, respectively.

2. Sutter’s operating expenses climbed 4.3 percent year over year to $6.1 billion in the six months ended June 30.

3. Sutter ended the first half of 2018 with operating income of $145 million, up 806 percent from $16 million in the same period of 2017. The health system’s operating margin increased from 0.3 percent in the first half of 2017 to 2.3 percent in the first six months of 2018.

4. After factoring in investment income, which declined due to a drop in value of certain securities and debt extinguishment, Sutter’s net income was $174 million in the first six months of this year, compared to $350 million in the same period a year earlier.

 

 

California city anticipates 1,200 jobs spurred by Kaiser, Adventist and Sutter expansions

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/workforce/california-city-anticipates-1-200-jobs-spurred-by-kaiser-adventist-and-sutter-expansions.html

Image result for California city anticipates 1,200 jobs spurred by Kaiser, Adventist and Sutter expansions

 

The city of Roseville, Calif., anticipates a job boom as healthcare giants Kaiser Permanente, Adventist Health and Sutter Health expand in the area, reports The Sacramento Bee.

The area is expected to see about 1,200 more jobs over several years resulting from the projects.

“We are expecting a significant, 11 percent job growth over the next five years, and these expansions play into that,” Laura Matteoli, the city’s acting economic development director, told the publication.

Roseville, Calif.-based Adventist Health’s plans involve consolidation. According to the report, the system will consolidate its corporate headquarters and other buildings into one 275,000-square-foot building, projected to cost $100 million and slated to open in January. Human resources, IT and strategy departments will be housed in the building. Adventist Health also is building a clinic for its workers in Roseville, vice president of talent strategy Doris Tetz Carpenter told The Sacramento Bee.

Oakland, Calif.-based Kaiser Permanente’s plans in Roseville involve replacing its 90,000-square-foot Riverside Medical Offices with one 210,000-square-foot building that will offer outpatient services, spokesperson Edwin Garcia said.

At Sacramento, Calif.-based Sutter Health, hospital officials are expanding the system’s Roseville hospital’s emergency and intensive care unit, the report states. The 97,000-square-foot building addition is slated for completion in 2020.

 

 

California attorney general sues Sutter Health for anticompetitive practices

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , • Leave a comment

https://www.fiercehealthcare.com/regulatory/california-ag-sues-sutter-health-for-anticompetitive-practices?mkt_tok=eyJpIjoiTkdNMU56bGxOVGRpWlRRMyIsInQiOiJOQmExNkliUVBkRFNHMGRBUFZiRG5MazRJVHJxQjFvRTl3NjVNV0pxeDlHc0dyVEhBS01HRjlcL1ZLaXFcL3hpOHVzVkxtdEpZb1BPYTc3SE82VnN3U05nejlNNEVOWUhhY2h2NThFdUluTjY1SU5zUkgxZEExRTFTemI5a3dSNkZJIn0%3D&mrkid=959610

Gavel

California’s attorney general has filed a lawsuit against Sutter Health, the largest system in the northern part of the state, claiming the organization’s anticompetitive practices have driven up healthcare prices throughout the region

The charges in the lawsuit (PDF) are “not new to Sutter,” AG Xavier Becerra said at a press conference Friday afternoon. The filing follows a statewide investigation into healthcare costs that revealed wide price disparities between the northern and southern parts of the state.

“Sutter Health is throwing its weight around in the healthcare market, engaging in illegal, anticompetitive pricing that hurts California families,” Becerra said in an announcement. “Big business should not be able to throttle competition at the expense of patients.”

Sutter was able to jack up prices for care at its facilities in several ways, according to the lawsuit:

  • Forcing insurance companies to negotiate with it in an “all-or-nothing” systemwide fashion
  • Blocking payers from offering patients low-cost health plan options
  • Charging extremely high rates for out-of-network visits
  • Limiting price transparency

Karen Garner, a spokesperson for Sutter, said in a statement emailed to FierceHealthcare that the system is “aware that a complaint was filed, but we have not seen it at this time, so we cannot comment on specific claims.”

Garner said that data from the state’s Office of Statewide Health Planning and Development show lower prices at Sutter Health facilities compared to other providers operating in Northern California. Sutter has also kept rate increases for its health plan in “low single digits since 2012,” she said.

“It’s also important to note that healthy competition and choice exists across Northern California,” Garner said. “There are 15 major hospital systems and 142 hospitals in Northern California, including Kaiser Permanente, Dignity, Adventist, Tenet, UC and more. And health plans can elect to include or exclude parts of the Sutter Health system from their networks, and health plans have been doing so for many years.”

Multiple California employers and labor unions have taken action against the health system for anticompetitive practices prior to the AG’s involvement. Sutter came under fire late last year after it was revealed that in 2015 it destroyed 192 boxes of documents that these entities sought as evidence, which the system said was a regrettable mistake.

A California judge said there was “no good reason” for Sutter to have destroyed the documents and said the “most generous interpretation” was that the system was “grossly reckless.”

The AG’s lawsuit also alleges that in addition to driving up healthcare costs in Northern California, Sutter’s actions enriched its executives, and fueled acquisitions that led to further consolidation and funding for its own health plan.

Becerra’s office was spurred to act, according to the announcement, following the release earlier this week of a report from the University of California that detailed how much consolidation has impacted healthcare costs in the state, with northern regions especially affected.

The average cost for an inpatient stay in Northern California was $223,278, compared to an average of $131,586 in the southern regions, according to the report (PDF).

Kathleen Foote, senior assistant attorney general in California who heads the antitrust unit, said at the press conference that taking action against Sutter’s practices should lead to increased competition that benefits both price and care quality.

A video of the full press conference is embedded below:

 

 

State of California files suit against Sutter Health over antitrust allegations

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , , , , • Leave a comment

https://www.bizjournals.com/sanfrancisco/news/2018/03/30/state-files-antitrust-suit-against-sutter-health.html

Sutter Medical Center in Sacramento

The State of California on Friday filed an antitrust suit against Sutter Health, accusing the Sacramento-based health system of practices that have driven up the cost of care in Northern California.

Sutter is accused of preventing insurance companies from negotiating with the health system on anything but an all-or-nothing basis, which requires insurers to contract with the entire health system, and not just parts of it. The lawsuit also alleges the health system has prevented insurance companies from offering low-cost health plan options and set excessively high out-of-network rates, while restricting the publication of provider cost information for patients’ review.

A Los Angeles Times analysis of medical care costs, which is referenced in the lawsuit, found that hospitals in Northern California’s six most populous counties collect about 56 percent more revenue per patient per day from insurance companies and patients compared to hospitals in Southern California’s six largest counties.

At a news conference this morning, Attorney General Xavier Becerra said the investigation has been in the works for about six years, prompted by complaints from patients and employers about high medical care costs in Northern California.

“It’s time to hold health care corporations accountable,” Becerra said at the news conference. “If we do nothing, it will continue to happen.”

The state attorney general’s office said in a statement that the “excess profits” Sutter took in from its allegedly illegal conduct was put toward “waves of acquisitions, extreme levels of executive compensation and financing its own insurance arm.”

“Much of the increased cost of health care in Northern California is attributable to Sutter and its anticompetitive contractual practices which it has imposed as a result of its market power,” the complaint against Sutter states. “Specifically, Sutter embarked on an intentional, and successful, strategy of 
securing market power in certain local markets in Northern California.”

The lawsuit seeks to enjoin Sutter from continuing its allegedly illegal contracting practices, including all-or-nothing contract negotiations and so-called price-secrecy terms. The lawsuit also seeks to “restore competition” by requiring Sutter to stagger its negotiations between its providers of inpatient services, outpatient services and affiliated physician groups that refer patients to non-Sutter hospitals.

The lawsuit also seeks to stop Sutter from transferring money earned by its health care providers to finance its health plan, Sutter Health Plus.

“We are aware that a complaint was filed, but we have not seen it at this time, so we cannot comment on specific claims,” said Karen Garner, a spokeswoman for Sutter, in an emailed statement. “It’s important to note that publicly available data (from the OSHPD) show that on average, total charges for an inpatient stay in a Sutter hospital are lower than what other Northern CA hospitals charge.” The OSHPD is the Office of Statewide Health Planning and Development.

 

Alta Bates emergency center will close, but Sutter Health says not as soon as people think

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

Alta Bates emergency center will close, but Sutter Health says not as soon as people think

People exit and enter Alta Bates Medical Center in Berkeley, Calif., on Friday, Feb. 2, 2018. Legislators, city officials and health care professionals will continue their public campaign against the closure of emergency care services at Alta Bates Medical Center, even as its parent organization, Sutter Health, insists it will keep the center open for the next decade, dispelling what it says is misinformation that has circulated about the hospital closing in 2019. (Ray Chavez/Bay Area News Group)

BERKELEY — Hospital services at Alta Bates Medical Center’s Berkeley campus will end, but not as soon as people think, company officials said this week.

In an ongoing debate over the future of emergency services at the campus, legislators, city officials and health care professionals will continue their public campaign against the closure while the hospital’s parent organization Sutter Health insists it will keep the campus open for at least a decade.

Nurses and local leaders will gather for a community forum Saturday on the Ed Roberts campus, calling on Sutter Health to keep Alta Bates open as a full hospital with inpatient and emergency care. Sutter Health, citing a California law that requires hospitals to complete seismic upgrades by 2030, announced in 2016 its plans to move inpatient care and emergency services from the Alta Bates site in Berkeley to an expanded, retrofitted Oakland campus.

This week, Sutter Health released a statement saying the emergency room and inpatient hospital services provided at the Alta Bates campus will remain in Berkeley until they are available in full at the Summit Medical Center campus in Oakland, which could take up to 10 years to build.

The memo was intended to clarify what Sutter Health leaders say is misinformation about the timing of the Alta Bates closure. While many people thought the hospital’s emergency care and inpatient services could close as early as 2019, the organization said this week it will be a decade before that happens.

“The memo is intended to highlight our commitment to community and do this gradually,” said Alta Bates Summit CEO Chuck Prosper by phone on Friday. “The last thing we want to do is create a shock.”

But for many health care workers and community advocates, the memo was not reassuring. They do not want the hospital and emergency room to close at all.

“Even in its own statement, Sutter admitted its plan is not to retain Alta Bates as a full service acute care hospital, and that it fully intends to force patients from Berkeley to Vallejo along the densely populated I-80 corridor to travel even farther to Oakland, further delaying life-saving emergency treatment,” said an email message from organizers from the California Nurses Association and Save Alta Bates Hospital campaign about Saturday’s public forum.

Sutter Health plans to enlarge its Oakland campus with a second building and will build urgent care clinics and outpatient services in Berkeley either at its Alta Bates campus on Ashby Avenue or the Herrick campus on Dwight Way.

Rochelle Pardue-Okimoto, a registered nurse at Alta Bates and El Cerrito’s mayor pro tem, said she’s concerned about the impact on care across hospitals in the area if Alta Bates’ acute care services close. She said her colleagues at hospitals around the East Bay have already seen busier emergency rooms following the closure in 2016 of Doctors Medical Center in San Pablo after years of financial loss. That hospital recorded about 33,000 visits per year, and its closure has left the area between Vallejo and Berkeley with only one hospital — Kaiser Permanente in Richmond.

“If you concentrate all the emergency care in Oakland, it’s just too many people,” Pardue-Okimoto said. “There will be increased wait times.”

According to the most recent data available online from the Office of Statewide Health Planning and Development, the Alta Bates campus had 45,336 emergency room visits in 2016.

When asked on Friday about how Sutter Health plans to ensure that people throughout the area can access emergency care, Prosper said he believes that offering more robust outpatient services could help cut down on the number of emergency room visits.

“We believe today that people come to the emergency room often not needing emergency care,” he said. “Some people come for primary care or other services because they do not have other access to medical care.”

He could not specify what percentage of emergency visits include people seeking non-emergency care, but said Sutter Health is interested in finding more information about that as it plans for the future. He also said that the movement of people who seek care is more “fluid” than people might believe, noting that people already “are routinely leaving Berkeley” to go to hospitals in Oakland or elsewhere.

Sutter Health officials have said they have no choice but to eventually close the acute care services at Alta Bates, as almost all of the Berkeley campus cannot be retrofitted to meet new state seismic standards for inpatient hospital care, and rebuilding would be too expensive.

Berkeley Mayor Jesse Arreguin, who started a task force to discuss the potential impacts of closing Alta Bates said there has been a lack of transparency around the closure of the hospital that makes it difficult to work with Sutter Health on future planning. While Sutter Health executives have said the buildings are not seismically safe, city officials do not know, for example, how much it would cost to retrofit or rebuild them.

“I believe Sutter needs to either save the hospital or sell it,” Arreguin said in an interview Friday. “We cannot make the East Bay a hospital desert.”

He said city officials have met with other hospital operators to discuss options for building another hospital with acute care services. But short of that happening, he hopes Sutter Health will work with the city to develop a plan.

“While it’s reasurring that Sutter said they were not closing next year, they did say they were going to close in 10 years,” Arreguin said. “We are still concerned with Sutter’s plans to close the hospital (at all), which they reaffirmed.”

 

Sutter will shift 10,000 Anthem Medi-Cal enrollees to community health centers

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

http://www.sacbee.com/news/local/health-and-medicine/article167900272.html

Image result for FQHC

 

In Sacramento and Placer counties, roughly 10,000 adult Medi-Cal enrollees with Anthem Blue Cross are learning this summer that Sutter’s primary-care doctors will no longer see them.

Instead, those patients are being shifted to primary-care doctors at community health centers such as Sacramento’s WellSpace Health or Auburn’s Chapa-De Indian Health, said Dr. Ken Ashley, the medical director for primary care at Sutter Medical Group. He said the change in providers will allow the patients to access more services.

“Some of the things that the (community health centers) can provide with the funding that they are receiving are things that sometimes we struggle to find for our Medi-Cal patients, things like optometry and dental, behavioral medicine,” Ashley said. “I feel like these patients are finally going to receive things I could not provide as their primary-care doctor. I’m OK with our partners helping to take care of these patients.”

Sutter, Dignity Health, UC Davis and other providers have all contributed funding and expertise to expand the network of community health centers, more formally known as federally qualified health centers.

The so-called FQHC’s have long been the primary-care delivery network for uninsured, low-income people across the country, but Sacramento did not have a strong network of the centers until the Affordable Care Act set aside funding to help them grow to meet the needs of an expanding Medicaid population.

That flood of new patients has swamped many primary-care providers and has made it harder for all patients to get appointments through commercial providers, Ashley said. Meanwhile, in meetings with the leaders of local FQHC’s, he and other leaders were hearing how those organizations had expanded services, lengthened hours and had capacity for more patients.

About a year ago at one of the meetings, Ashley said, all the attendees began to feel that, if they could shift Anthem’s adult Medi-Cal enrollees, they would improve the health of the primary-care delivery system for a broad set of customers.

“We’ve been having a difficult time getting all our patients in at the time they would like, where they would like,” Ashley said. “This is one more step to try to help allow the rest of the community to help us take care of all these patients.”

Jonathan Porteus, the CEO of Wellspace Health, also leads the Central Valley Health Network, a group of health centers up and down the Central Valley that manage almost 3 million visits a year. He said that Anthem began earlier this year investigating whether the FQHC’s truly had the capacity to absorb the adult Medi-Cal patients served through Sutter.

“We were notified – we being the federally qualified health centers – that this change was coming and that there was a keen interest to make sure that it was smooth, that people would not be left without access,” Porteus said. “The wisdom of Sutter and others has been to help our region have a network of federally qualified health centers, a true blanket of care for the first time ever. This is one of the early tests.”

Porteus said he knows that people have questions about whether the quality of care at his centers is on par with what they would receive from primary-care doctors. He said he welcomes those questions because they give him an opportunity to tell the WellSpace story.

“The Joint Commission, which is the accrediting body that accredits hospitals and shuts them down if they don’t think they’re good enough, has accredited us to be a patient-centered medical home, has accredited all our behavioral health,” Porteus said. “This is a standard many of our commercial colleagues in this community don’t have. If you went into some of these primary-care practices and asked them if they had Joint Commission accreditation for ambulatory care, they will tell you ‘no.’”

There will unquestionably be upheaval in this process for both doctors and patients, Ashley said.

Sutter’s pediatricians will continue to provide primary-care to Medi-Cal-enrolled children covered by Anthem Blue , and the insurer’s Medi-Cal enrollees also still will be able to access Sutter specialists. Sutter primary-care doctors will continue to see anyone on Regular Medi-Cal recipients whose medical providers are paid directly by the government.

Sutter Medical Center unveils $812 million Anderson Lucchetti Women’s and Children’s Center

Posted on by • Posted in Uncategorized • Tagged , , , , • Leave a comment

http://www.healthcarefinancenews.com/news/sutter-medical-center-unveils-812-million-anderson-lucchetti-women-and-children-center

The new neonatal intensive care unit on the seventh floor of the Anderson Lucchetti Women’s and Children’s Center.

The 10-story, 242-bed center is an acute care hospital offering neonatal and pediatric intensive care.