Health Net Announces Expansion of Cross-Border HMO
Health Net on Friday announced plans to expand Salud con Health Net -- an HMO that allows members to receive treatment from a network of providers in California and Mexico -- to Orange County, the Orange County Register reports. The plan has been available since 2000 in Los Angeles, San Diego and Ventura counties (Munoz/Wolfson, Orange County Register, 11/12).
Salud offers services through a network of Spanish-speaking doctors under the auspices of Clinica Medica General, a group of clinics dedicated to the Spanish-speaking community, as well as at Anaheim General Hospital. Members also can receive care in Tijuana, Mexicali and Tecate through Mexican HMO SIMSA's network.
About 33% of Orange County residents are Hispanic, and one-third of those residents work for employers who do not offer health insurance, the Register reports. In the state, 37% of Hispanics are uninsured, nearly twice the rate among the state's population as a whole (Wolfson/Munoz, Orange County Register, 11/12).
According to the Los Angeles Times, a traditional Health Net plan costs about $643 per month for a family of three.
Ana Andrade, the company's vice president for Latino programs, said Salud costs about $339 per month for a family of three. Andrade attributed the lower cost of Salud to lower health care costs in Mexico and reduced service fees that Health Net negotiated by guaranteeing patient volume levels (Mena, Los Angeles Times, 11/13). However, Andrade said that the HMO has been only "modestly successful" in other Southern California counties.
According to the Register, the Sept. 11 terrorist attacks are one of the "main reasons" the HMOs has not had higher participation.
Peter Duncan -- vice president of Blue Shield of California, which offers a similar plan, called Access Baja -- said, "September 11 unfortunately put a damper on the whole international movement of businesses and programs," adding, "But that has diminished over time."
Andrade added that another possible obstacle for the program could be educating Mexican immigrants about the U.S. health care system and the benefits of HMOs.
According to the Register, Health Net hopes the program will decrease the number of uninsured Hispanics and provide the company with "good will from the community."
Victor Blanco, founder of Clinica Medica, said the HMO will help treat an underserved population of patients who may feel more comfortable seeing Spanish-speaking doctors. Blanco said the plan also would be one of the first that is accessible to small businesses.
Andrade said, "We feel that our program is very appropriate for small businesses who currently cannot afford to provide healthcare benefits to their employees," adding, "With our expansion, we are poised for what we consider to be tremendous growth" (Wolfson/Munoz, Orange County Register, 11/12).
Isabel Becerra, chief operating officer of the Coalition of Orange County Community Clinics, said, "There is a huge pool of individuals who go to Tijuana to get medications and see doctors. If they can do that in an insured way ... that would be ideal" (Munoz/Wolfson, Orange County Register, 11/12).