HEALTH SYSTEMS: The Valley Vs. The Hill
Hill Physicians Medical Group and PacifiCare HMO are "diverting a handful of patients away from ValleyCare Health System hospitals in Pleasanton and Livermore, sending them to San Ramon Regional Medical Center and Eden Medical Center for inpatient care" in what some are calling a battle for control of the area's health care market. The Tri-Valley Herald reports that ValleyCare officials "are responding ... by urging those who live in the Livermore-Amador Valley to choose doctors carefully if they wish to be treated by a hospital close to home," contending that "Hill is driven by valid business concerns with less regard for patient convenience." Hill says, "ValleyCare is trying to push Hill out of the health care market" in those areas. Darryl Cardoza, COO of Hill, said, "Fundamentally, this is about ValleyCare trying to survive as an independent entity. They are trying to blow this out of proportion to get us out of the Valley entirely." Pamela Friedman, vice president of business development and managed care at ValleyCare, said, "It's not an economic interest for us. But it is a huge convenience factor for the person who has to be sent up the road to be admitted. That is what I am concerned about."
He Said, She Said
Hill "serves about 20,000 patients in the Livermore-Amador Valley through contracts with several HMOs." It is the "biggest independent practice association in Northern California, with more than 2,000 doctors and 330,000 patients enrolled." The Herald reports that "PacifiCare asked ValleyCare to reduce inpatient contract rates, including for Hill patients," but "ValleyCare ultimately declined." Friedman said, "(PacifiCare) asked us for a contract rate that was lower than the incredibly low rates we offer. We think our rates are pretty low already." She said, "ValleyCare's refusal to reduce contract rates to PacifiCare for Hill patients is part of the reason the physicians' group is diverting patients to other hospitals." Cordoza said, "ValleyCare is to blame for the problem." He said, "ValleyCare has refused to negotiate a contract with PacifiCare to pay for services for Hill patients on a capitated basis," a charge that ValleyCare denies (Montiel, 5/10).