CMA Warns of Pending Doctor Shortage; Sechrist Buys Wound Care Group
For years, California’s prominent healthcare delivery model has centered on organized groups of doctors accepting the responsibility for managing the care of health maintenance organization enrollees.
The Integrated Healthcare Association, a Walnut Creek-based industry group that studies health policy and managed care issues, decided to take a look at how the model is working.
The group, which includes doctors’ groups, health plans and healthcare systems, recently released an update of its original August 1999 study.
The association concludes that the delegated model has lowered healthcare costs and improved quality.
But it also noted that business relationships between health plans and physician groups aren’t particularly warm and need to evolve into more of a mutual partnership.
“In other industries, a great deal of work has been done to integrate and align suppliers so that there is transparency across the entire enterprise and each is committed to the other’s success,” a report summary said. “That is far from the case here, making it very difficult for either plans or providers to thrive.”
The association also wants to see physician group consolidation, said Beau Carter, its executive director. “If you look at medical groups in California, the top performers (always have) been well-run, stable, know their costs and have reserves,” Carter said. By contrast, medical groups “that are set up as revenue capture points probably should go out of business.”
Orange County had a prominent example of that last year, when Anaheim-based KPC Medical Management Inc. flamed out. KPC was engulfed in management problems and failed at attempts to extract higher payments for services from the health plans it contracted with.
For its study, the Integrated Healthcare Association interviewed 10 large doctor groups throughout the state and four health plans that were committed to the so-called delegated delivery model.
The plans were Santa Ana-based PacifiCare Health Systems Inc., along with Blue Cross of California, Blue Shield of California and Health Net.
CMA Sees Doc Shortage
Sniping between California doctors and health plans flared again this month, when the California Medical Association released ” And Then There Were None,The Coming Physician Supply Problem.”
The survey was drawn from responses of around 2,300 of the Sacramento-based professional group’s 19,000 members. Among other things, responding doctors expressed their frustrations with low service reimbursements from health insurance carriers, reduced time with patients and shortages of certain specialty doctors, including neurologists.
“We know that in some parts of California, physician supply has dwindled and patient care is compromised,” said Dr. Jack Lewin, the association’s chief executive. “This survey shows that this trend is in danger of spreading to all corners of the state. This is bad news for healthcare.”
The California Association of Health Plans immediately responded, alleging that the medical group released the survey to gain support for a proposed state law that would grant physicians an antitrust exemption and allow them to directly negotiate with insurance companies. The state Senate Judiciary Committee held the proposal until the Senate comes back from recess next month.
Sechrist Expands Wound Care Unit
Sechrist Clinical Services, Anaheim, acquired Wound Care Group Inc. of San Antonio for an undisclosed amount. The combined business will be called Praxis Clinical Services.
The former Sechrist Clinical Services is a privately held subsidiary of Anaheim-based Sechrist Industries Inc., a provider of clinical hyperbaric, or wound care, equipment.
Sechrist Clinical Services operated and manages 20 wound-care centers throughout the United States.
The addition of Wound Care Group brings that total to 38 for Praxis, said Terry Bayer, the unit’s president, in a release. None of the wound centers are in Orange County,the closest is at Glendale Memorial Hospital.
Wound Care Group was formerly owned by Renal Care Group Inc., a publicly traded dialysis provider based in Nashville, Tenn.
According to figures provided by Praxis, wound care is a form of medicine that largely targets people older than 65. Conditions frequently treated include diabetic ulceration and venous stasis ulcers.
Bits and Pieces:
TriZetto Group Inc., Newport Beach, is providing its HealthWeb Internet platform and Erisco Facets software to HealthNow New York, a Blue Cross Blue Shield licensee with 750,000 members UCI Medical Center, Orange, is included in a U.S. News and World Report list of best hospitals for gynecology Water Pik Technologies Inc., Newport Beach, and Volan Design LLC of Boulder, Colo., won an award from the Industrial Designers Society of America for Water Pik’s flossing machine.
