Elected officials from the city, county and the health care district say they’re dissatisfied with a response from Sutter Coast Hospital to a joint resolution that urged, among other things, the hospital no longer contract with entities operating out of network for most local insurers.
The Del Norte Board of Supervisors and the Del Norte Healthcare District board on Tuesday reached a consensus to take their case directly to Envision Healthcare, formerly known as EmCare, the physician’s group that staffs Sutter Coast Hospital’s emergency room.
Crescent City Mayor Blake Inscore said he would bring the matter before city council for discussion next week.
Inscore, Councilor Heidi Kime, Supervisors Lori Cowan and Roger Gitlin and healthcare district board members Dr. Greg Duncan and Dwayne Reichlin met on Monday to discuss Hanna’s response to the joint resolution, which was approved by the three governing bodies in April and May.
The healthcare district board since December 2016 has urged hospital representatives to renegotiate its contract with Envision Healthcare due to the group’s out-of-network status with most Del Norte County insurance providers.
Last month Sutter Coast Hospital Administrator Carlos Priestly told the healthcare district board CEO Mitch Hanna gave Envision Healthcare until Jan. 1 to demonstrate evidence it is negotiating with local insurance providers. This did not satisfy the healthcare district board.
“This has taken a toll on working families and businesses that I would like to see remedied sooner,” said Duncan, who was elected to the healthcare district board in November. “One of the items that went back to the city council and the board of supervisors was to send the joint resolution on EmCare and the hospital directly to EmCare because they may not be aware of what’s going on.”
The joint resolution noted Sutter Coast Hospital is the only hospital in Del Norte County and its board meetings are closed to the public. The resolution noted charges for care at Sutter Health facilities, including Sutter Coast, exceed the charges for care at non-Sutter affiliated facilities.
The resolution urged Sutter Coast Hospital Board of Directors: “(1) Sutter Coast Hospital produce its meeting minutes and financial records since 2011 for public review; (2) Sutter Coast Hospital prominently display its charges for common services and procedures, including laboratory tests, imaging studies and fees from physicians either contracted with, or directly employed by, Sutter Coast Hospital; (3) The local members of the Sutter Coast Hospital Board of Directors hold regular public meetings to allow for public input regarding hospital operations; (4) Sutter Coast Hospital no longer engage in professional service contracts with individuals or entities, including EmCare Holdings, Inc., which operate ‘out of network for local insurance plans.’”
In an Aug. 18 letter to the Crescent City Council and Del Norte County Board of Supervisors, Hanna stated the hospital publicly provides a copy of its chargemaster and has posted a list of 60 of its most common procedures and charges.
However, Hanna stated the Sutter Coast Hospital board of directors isn’t willing to hold public meetings and isn’t required to make its meeting minutes or financial records public other than as required by law.
“Sutter Coast Hospital is not a district hospital, which is required to hold public meetings,” Hanna stated. “As a health care entity, we are highly regulated and subject to a wide range of laws and regulations, including but not limited to anti-trust laws and health care laws that generally prohibit us from sharing competitively sensitive information and information about our patients and employees.... We believe discussions with members of our board can be best accomplished by participating in the 2X2 healthcare subcommittee.”
When it came to Envision Healthcare and other contractors that operate out-of-network locally, Hanna said the Sutter Coast board chose the physician’s group based on its ability to fully staff the emergency department. He noted that Envision works in emergency departments at Mad River Community Hospital in Arcata, St. Joseph Health in Eureka and Curry Medical Center in Gold Beach. Envision received 1,787 calls from Sutter Coast Hospital last year with 35, or 1.9 percent, being related to out-of-network status, Hanna said.
“We understand that Envision is currently working to bring both Anthem Blue Cross and Blue Shield in-network by the end of the year. Understanding the concerns of our patients, we will continuously look for alternate providers to best meet the needs of our community,” Hanna told the city council and board of supervisors.
In a Coastal Voices op-ed published Tuesday in the Triplicate, Hanna said he has asked Envision to accept more local insurers.
“We have given Envision until the end of the year to find a solution and continue to explore other alternatives should that become necessary,” Hanna wrote.
According to Gitlin, in addition to forwarding the joint resolution to Envision Healthcare, he and his fellow elected officials on Monday discussed sending a copy to Sutter Health President and CEO Sarah Krevans as well as state Sen. Mike McGuire, Assemblyman Jim Wood and Congressman Jared Huffman.
Gitlin said he, Inscore, Kime, Cowan, Duncan and Reichlin also discussed the possibility of a legislative action to allow an elected official to have access to the Sutter Coast Hospital board of directors meetings.
“We continue to receive complaints and comments, negative comments,” Gitlin said. “We’d like to see some action. There’s a lot of talk and really no action. That is the position of our 2 by 2 health care board. All four of us agree that we’re going to take this to the next level.”
Inscore said he appreciated Hanna’s statement to Envision representatives to begin working with local insurers by Jan. 1, 2018, but the problem needs to be solved sooner, which is why he and his fellow elected officials are reaching out to Envision Healthcare.
“If I’m going to lobby for the people I represent, I want changes made as soon as possible,” Inscore said. “I guess to me it’s trying to accomplish the same thing using two different venues or approaches.”
Inscore noted that Anthem Blue Cross and Blue Shield were two major insurers for Del Norte County residents.
Reach Jessica Cejnar at email@example.com.