SONOMA COUNTY: Specialty Physician to Disband
"The financially failing Specialty Physician Alliance will be disbanded, leaving 250 Sonoma County doctors holding millions in unpaid claims that some say could drive them out of business," the Santa Rosa Press Democrat reports. The group serves an estimated 80,000 members in the Santa Rosa area, and the news immediately raised fears about specialty access for patients. Santa Rose endocrinologist David Price said, "It's a horrible situation and I think it's going to drive a lot of people (doctors) out of town." The alliance's two main insurers, Health Plan of the Redwoods and the Redwood Empire Medical Group, "have offered to negotiate new arrangements with individual doctors so patients will be able to see a specialist when necessary."
Bottom Line Blues
Some doctors voiced fears, however, about the financial stability of their own practices "because of the alliance's problems and low reimbursements" from HMOs. The alliance is reportedly "tens of thousands of dollars behind in processing claims." Dr. Price said he was owed about $20,000 and one large oncology partnership said it was owed $1.5 million. Officials with the alliance could detail neither how it was going to pay doctors or "exactly how much money the alliance has." Auditors are currently reviewing the alliance's financial history, "hoping to find how it got hundreds of thousands of dollars behind in paying its member doctors." They are focusing on the group's former claims administrator, Pro Med Health Care Administrator of Pomona. Dr. Price commented that ultimately the failure of the alliance was a "series of failures" by all those involved. He said the physician contracts "undervalued the product, the doctors were silly enough to take the risk and SPA didn't have the administrative oversight" (Carter, 7/30).