Ventura Co. Medi-Cal Plan Struggles To Sign Up Anesthesiologists

Anesthesiologists in some Ventura County cities have rejected contract offers from Gold Coast Health Plan, and health care advocates say the situation could compromise beneficiaries' access to care, the Ventura County Star reports.

Background

Anesthesiologists are contracted health care providers, so they are not employees of the hospitals they work in. They decide whether to accept Medi-Cal, California's Medicaid program.

Health care advocates have said that the lack of contracted anesthesiologists at some hospitals means that some patients have to switch physicians and face delays of several weeks for surgeries. The affected hospitals include St. John's Regional Medical Center in Oxnard, St. John's Pleasant Valley Hospital in Camarillo and Los Robles Hospital & Medical Center in Thousand Oaks.

While the hospitals cover emergency surgeries for Medi-Cal beneficiaries, nearly all planned or elective surgeries are performed at facilities where anesthesiologists contract with Gold Coast Health Plan.

Gold Coast Health Plan operates Medi-Cal in Ventura County for more than 100,000 low-income residents. Earlier this year, Gold Coast Health Plan took over Medi-Cal operations in the county from the California Department of Health Care Services.

Doctors said low Medi-Cal reimbursement rates were one reason for the contract rejections. California's Medi-Cal reimbursement rates are among the lowest in the U.S. and were reduced by an additional 10% last month.

Responses

Norman Williams, a spokesperson for the DHCS, said state officials are aware of the contract negotiations. He said that although the hospitals have not entered into a contract with Gold Coast Health Plan, the managed care plan still meets state requirements governing access to care.

Gold Coast Health Plan CEO Earl Greenia said the plan offers "excellent access" for patients, adding, "We have far exceeded the state member-to-physician ratio" (Kisken, Ventura County Star, 11/11).