Ten Sacramento Hospitals Make Preferred List in PacifiCare’s New ‘Network Within a Network’ Plan

Ten hospitals in the Sacramento area will be on PacifiCare's select list of hospitals when it introduces a new HMO plan next year designed to "channel patients" to facilities with lower reimbursement rates, the Sacramento Business Journal reports. PacifiCare is one of several California managed care organizations introducing a "network within a network" plan in which members will have to pay steep copayments --- between $100 and $400 per hospital stay -- if they use hospitals that are not on the health plan's "A" list. The University of California-Davis Medical Center is the only "major" Sacramento-area hospital that did not make the list for PacifiCare's Select Hospital Benefit Plan, which is "now being marketed statewide." All local hospitals owned by Sutter Health and Mercy Healthcare made the list. Kaiser Permanente's three local hospitals "don't count because they form their own health care system and health plan," and Marshall Hospital in Placerville no longer contracts with PacifiCare. "In the Sacramento area, it appears we were able to secure favorable rates with most of the hospitals," PacifiCare spokesperson Cheryl Randolph said, adding that seven hospitals made the "A" list in San Francisco, including UC-San Francisco Medical Center. Throughout the state, roughly 50% of the 230 hospitals in PacifiCare's network will be on the select list. The new plan is expected to save businesses 5% to 20% on premiums by steering patients towards less expensive hospitals (Robertson, Sacramento Business Journal, 10/26).