Contract Dispute Between Health Plan of the Redwoods and St. Joseph Health Foundation Ends
After six months of talks, contract negotiations between the Health Plan of the Redwoods and doctors from the Sonoma County-based St. Joseph Health Foundation have ended successfully, the Santa Rosa Press Democrat reports. Health Plan of the Redwoods CEO John Baxter said that all but 10 of the 28,000 HPR beneficiaries with foundation physicians will be able to keep their primary care doctors next year when the new contracts begin. The dispute between the foundation's 100 primary care doctors and 250 specialists and HPR began in June when the foundation said that it would stop accepting HMO beneficiaries covered by capitation payments. Echoing a frequent complaint of doctors, the medical group said that these payments, under which a health plan pays a provider a fixed payment per patient per month regardless of the amount of care provided, do not cover the cost of care. That declaration set the stage for a "stalemate" with HPR that was resolved "just days ahead" of a Dec. 1 deadline to reach an agreement. The new fee-for-service contract marks a shift away from capitation payments, which will mean "additional money and medical freedoms" for doctors. The Press Democrat reports that providers and hospitals could see 10% increases in revenue next year because of the new deals. However, the new contracts also mean higher premiums for employers, which are expected to rise 15% in Sonoma County next year. Doctors "now have the upper hand in contract negotiations with the HMOs," Kirby Hutson, a health care consultant with the benefits firm William Mercer of San Francisco, said, adding, "That shows up in the premiums that employers have to pay." Another Sonoma doctors' group, Sutter Medical Group of the Redwoods, has chosen to keep capitated contracts with HPR. "If either party decides another type of relationship will be more effective in the future, we'll work on the details at that time to ensure that HPR members get needed medical care," Baxter said (Rose, Santa Rosa Press Democrat, 12/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.