Santa Rosa Cancer Patients May Face Increased Costs After Oncologists, Health Foundation Contract Expires
With a contract between the Redwood Regional Oncology Center and the St. Joseph Health Foundation set to expire, about 800 cancer patients who receive treatment at the Santa Rosa-based center may have to pay for the cost of treatment "up front" after July 1, the Santa Rosa Press Democrat reports. St. Joseph serves as the contracting agency for cancer patients in Sonoma County who have insurance through Health Plan of the Redwoods, HealthNet, PacifiCare, Blue Cross, Blue Shield and Aetna. Under the current system, the health plans contract with the foundation's group of primary care physicians, who contract with specialists at Redwood. However, on June 30, the contract between the oncology center and the foundation will expire. Contract negotiations between St. Joseph's and Redwood broke down over reimbursement rates. According to the Press-Democrat, Redwood doctors had asked for a 10% increase in reimbursement rates -- the "bottom line at which oncologists figured they could continue to provide treatment" -- but St. Joseph rejected the proposal. Dr. Gary Greensweig, president of St. Joseph, called Redwood's request for a rate increase "not unreasonable, just unaffordable." He added that case managers at the foundation would "work to make sure" that patients could "obtain continued treatment" at the center.
The Press-Democrat reports that the oncology center mailed letters Wednesday to hundreds of physicians, notifying them that cancer patients they referred to the center would have to pay higher rates "because of the lack of a contract." Dr. David Schmidt, president of Redwood, said, "Oncology patients have every right to be upset and I feel badly for them. We would have liked to come to terms with St. Joseph without this." While about 800 patients received letters, only about 125 to 150 of them are receiving "active treatment," the Press Democrat reports. HPR, which covers many of the patients, said that members would not have to "pay cash for treatments," which cost up to $10,000. The health plan will reimburse the cancer center under "continued care" provisions, HPR officials said (Rose, Santa Rosa Press Democrat, 6/21).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.