SAN DIEGO: Surgical Group Drops Mercy Contract Over ‘Insufficient’ Payments
Calling payments from Mercy Physicians Medical Group East "insufficient to sustain them," the San Diego Surgical Specialists Medical Group has ended its contract with Mercy and may do the same with Family Health Network next month, the San Diego Union-Tribune reports. San Diego Surgical, made up of 120 surgeons from throughout the San Diego area and 35 in East County, receives a fixed payment from insurers like Mercy to care for patients. Shaun Edelstein, San Diego Surgical administrator, said that because the physician group's rates were 60-65% of Medicare rates, the group had to use its emergency funding to stay afloat. He added, "The bottom line is that there are 30,000 patients in the East County that are managed care refugees" because they will no longer be able to use San Diego Surgical services. Meanwhile, Dr. Ned Chambers, president of Family Health Network, said that its contract negotiations with San Diego Surgical will continue, predicting that they "will be successful for both sides." A "widely circulated" report from the California Medical Association last fall estimated that the average monthly rate physician groups receive dropped 35% between 1993 and 1999, "putting as much as 90% of medical groups and independent physician associations ... in financial jeopardy" (Fong, 8/12).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.