HMOs Seek to Shift Patients Out of KPC

Health plans seeking the Department of Managed Health Care's approval on contingency plans to move patients out of physicians groups belonging to financially ailing KPC Medical Management, the Orange County Register reports. DMHC Director Daniel Zingale said, "[Health plans] are certainly putting forward ambitious transition plans. They are acknowledging that a large number of patients may need to be transitioned." During "intense, hours-long" conference calls on Wednesday and Thursday, HMOs voiced their "concerns" to state officials about the "financial viability" of the Anaheim-based KPC, although no conclusions were reached. Last week, KPC President Donald Smallwood said that the group had not yet received the full amount of the $30 million loan from health plans to help the group pay off its debts. Earlier this week, the DMHC granted Blue Cross of California's request to transfer 14,000 patients from KPC's Artesia Mullikin practice to Pioneer Medical Group, which was formed two months ago by physicians who "defected" from KPC. Blue Cross spokesperson Michael Chee said the insurance company decided to switch the patients "so they could stick with their primary care physicians." Zingale said that HMOs have been "quietly" shuffling patients from KPC to other providers over the past few months, causing KPC's patient pool to drop from more than 500,000 patients earlier this year to about 250,000. The declining patient rolls lead to a decrease in revenue for KPC, causing health plans to "fret even more" about its financial state. Zingale noted that, should KPC "go under," he is "confident" that other medical providers will be able to handle KPC patients. KPC officials did not comment on the issue (Wolfson, Orange County Register, 11/17).