Sutter Coast Hospital has asked Envision Healthcare, formerly known as EmCare, to find a way to work with local insurance carriers or we would look for another emergency medicine (provider), according to hospital Administrator Carlos Priestly.
Priestly made this announcement at a Del Norte Healthcare District Board meeting Tuesday in the wake of a New York Times article highlighting the providers billing practices and following criticism from the public including the healthcare district board, the Del Norte County Board of Supervisors and the Crescent City Council.
Priestly said hospital CEO Mitch Hanna told EmCare representatives they need to demonstrate evidence that they are negotiating contracts with local insurance carriers by Jan. 1.
Mitch has been direct either you do this or (were) moving on, Priestly said. He needs to see evidence. Could I describe that evidence he might be looking for at this point? No. We need to know, we need to feel in our gut and our hearts that they are actually doing something.
The Del Norte Healthcare District has urged hospital representatives to renegotiate its contract with Envision Healthcare since Dr. Greg Duncan was elected to the board in November 2016. Duncan, who said patients have been bringing their hospital bills to him during the 24 years hes practiced in Crescent City, has stated that Envision Healthcare has been charging $2,054 for its highest level billing code, which is about triple to what its predecessor, Valley Emergency Physicians, charged.
Duncan has also asked Sutter Coast Hospital representatives to provide a list of charges local patients incur for common procedures. This request and the request for the hospital to renegotiate its contract with EmCare culminated in a joint resolution from the Del Norte Board of Supervisors, the healthcare district and the Crescent City Council.
In response to posting Sutters prices, Priestly stated that a 2017 amendment to Californias Payers Bill of Rights administrative code requires acute care hospitals post in a public place its 65 most common charges.
If you come to Sutter Coast in the main hallway we have a glass case, youll see those 65 of the most common charges and their associated prices posted, he said. That is a direct result of the change to the Payer Bill of Rights that mandates every acute care hospital in the state of California must post this information.
Priestlys announcement about Envision Healthcare came as a surprise to members of the Del Norte Healthcare District Board. Both Duncan and his colleague on the board, Dr. Kevin Caldwell, asked if the deadline Hanna gave to the provider could be moved up.
Im worried that were going to go four months and then theyre going to say Really, we asked for it, were going to put it in, Caldwell said.
Envision Healthcare is a large national provider and staffs emergency departments at Mad River Community Hospital in Arcata, St. Joseph Health in Eureka and Curry Medical Center in Gold Beach.
On Aug. 15, the Triplicate quoted Hanna, who said the EmCare call center received 1,787 calls from Sutter Coast Hospital patients in 2016 with 35 or 1.9 percent of them related to out-of-network status.
Hanna said California hospitals arent allowed to directly hire physicians, including those who work in the emergency department. Because these independent businesses manage their own operations, a patient may obtain services from an in-network hospital and still be billed for an out-of-network specialist, Hanna told the Triplicate.
In other matters Tuesday, the Del Norte Healthcare District unanimously approved a $74,300 proposal from Vanir Construction Management Inc. to develop plans for expanding the Open Door Clinic. Vanir will also conduct a feasibility study for establishing an outpatient surgery center and imaging center at the clinic and will also develop plans for a hospitality suite for visiting health care providers, according to the proposal.
Vanir lead planner, Jim Aboytes, was the construction consultant who worked with the architect to build the Del Norte Wellness Center, which houses the Open Door Clinic. The facility was completed about 10 years ago and was built in a way that allows for expansion.