UCI Medical Center Announces Plans To Withdraw from CalOPTIMA Network
University of California-Irvine Medical Center officials notified CalOPTIMA, the Medi-Cal administrator in Orange County, that after Dec. 31 it will no longer serve as a primary provider of hospital services in the agency's managed care system because of "growing financial losses," the Orange County Register reports. The decision affects about 20,000 patients within the UCI network, as well as about 1,900 children enrolled in Healthy Families, which CalOPTIMA also administers in Orange County.
Susan Rayburn, a UCI vice president, in a letter to CalOPTIMA attributed the decision to "payments that are not adjusted for risk and are not keeping pace with the growing costs of providing care."
UCI is negotiating a deal with Monarch Healthcare that would allow doctors at UCI clinics to join Monarch to prevent patients from having to switch doctors.
Cygan also said UCI will still offer specialized care that is unavailable at other facilities under a deal reached with CalOPTIMA.
Officials at Children's Hospital of Orange County also told CalOPTIMA that the facility will withdraw from CalOPTIMA's United Care Medical Networks but will remain in its CHOC Health Alliance network.
UCMN has about 20,000 enrollees, about half of whom are children and likely will continue to receive services at CHOC, according to CHOC CFO Kerri Ruppert. She said the other affected patients are adults who do not receive services at CHOC (Wolfson, Orange County Register, 7/15).