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Trying To Bridge Gap Between Direct Hiring, Access

It’s a bill that keeps coming up — by the same author three years in a row, and in three different forms in the previous legislative session. But this time around, Assembly member Sandré Swanson (D-Alameda) swears it will be different.

And for one day, at least, it was.

Swanson’s bill, AB 1360, on Monday passed out of the Assembly Committee on Business, Professions and Consumer Protection on a 5-3 vote. It now heads to the health committee. It’s a bill that attempts to address the shortage of physicians in underserved and rural areas by allowing some hospitals in those districts to hire them directly. The idea is medical facilities would be better able to attract physicians – particularly primary care doctors – if they were allowed to negotiate directly with them. 

“Everyone sees there’s a mal-distribution of physicians in this state,” Swanson said. Even when many Californians are covered by Medi-Cal, they can’t necessarily find a physician anywhere near them, he said. “About 3 million of these Californians can’t get care. And that will be heightened by the additional number of enrolled patients [starting] in 2014. We think this bill will get us ahead of the curve on this.”

Primary opposition to this bill comes from physicians who worry that if physicians become hospital employees, hospital administrators would have more influence over physicians and their medical decisions, which could compromise patient care.

There is no evidence to support that claim, Swanson said. “It’s an assertion of a problem, but there’s no evidence about it,”  Swanson said.

A pilot program in which rural hospitals hired physicians in California ended last year. Swanson’s bill significantly expands the scope of that pilot program.

For instance, the pilot had a provision that eligible hospitals had to serve at least 50% Medi-Cal and Medicare patients. Swanson’s bill doesn’t include a target percentage, though he says it still might.

“We’re looking at that question,” he said. “I don’t have any problem with that percentage. We’re meeting with the CMA [California Medical Association] to try to work out the details before it goes to the health committee.”

AB 1360 is scheduled to go before the Assembly Committee on Health on Apr. 26, but Swanson said it will likely be pushed to the subsequent committee meeting on May 3 — to give more time to meet with the CMA.

“I’m willing to look at any reasonable amendments to this policy,” Swanson said. “Because doing nothing is not an option.”



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