PacifiCare, State Try to Reduce Member Complaints
Swedish Opens Dermal Implant Unit; CHOC Fills Neonatal Void
HEALTHCARE by Vita Reed
Griping about managed healthcare plans, particularly health maintenance organizations, is commonplace.
With that in mind, Cypress-based PacifiCare of California and the California Department of Managed Health Care launched a program last year to help address concerns that PacifiCare members have about their healthcare.
The program is about to mark its first anniversary. PacifiCare and the department jointly fielded more than 400 phone calls from healthcare maintenance organization members in its first six months of existence.
But just 148 members have called in the last six months.
The program allows PacifiCare of California, its members and the Department of Managed Health Care to jointly work on questions about referrals, appeals, physician changes, billing and claims. The department says that working with PacifiCare representatives leads to quicker resolution on the majority of calls. “PacifiCare has worked closely with us to resolve the issues on the spot, and since the program piloted, the volume of calls has dramatically decreased because we have been able to address more member questions on our own,” said Daniel Zingale, the department’s director.
Decreasing call volume “is evidence that this program can serve as a template for all HMOs to more effectively help their members,” said James Frey, PacifiCare of California’s president.
The pilot program is also designed to eliminate excessive paperwork. Before the program was launched, member complaints were sent to the California Department of Corporations, which previously regulated health maintenance organizations, for a response. A state customer service representative would contact the health maintenance organization. The Department of Corporations then would issue a letter to the member explaining the health maintenance organization’s action.
PacifiCare of California is the largest unit of Santa Ana-based PacifiCare Health Systems Inc. and has about 200,000 members in Orange County. PacifiCare has about 3.4 million members in California, seven other Western states and Guam.
Swedes Open OC Unit
Vitrolife AB, a biomedical company that trades on the Stockholm Exchange, has opened an American unit, A-Life Inc., in Newport Beach. A-Life will focus on final clinical development and marketing of Hyalite, a dermal implant product.
Vitrolife said in a release that A-Life’s focus “is to penetrate the $300 million U.S. dermal injectable wrinkle removal market.”
The company’s dermal implant product is based on a compound called hyaluronan, which comes about through natural expression of bacterium Streptococcus equi.
Vitrolife’s Web site says that a “continuous fermentation and purification process yields ultra-pure clinical grade hyaluronan, which has the same characteristics as the human molecule, and is therefore biocompatible in humans. As no materials of animal origin are used, there is no risk of viral transfer between species.”
CHOC Boosts Neonatal
Orange-based Children’s Hospital of Orange County has expanded its neonatal intensive care unit. The new unit adds 10 beds, giving it a total of 42.
CHOC boosted the unit’s capacity for a pair of reasons, according to a hospital spokeswoman. She said the hospital is seeing greater demand for neonatal care and that its neighbor, St. Joseph Hospital, closed its neonatal intensive care unit in March.
Neonatal intensive care units help prematurely born infants. Thanks to technological advances, physicians are now saving babies who weigh as little as one pound at birth.
Bits and Pieces:
Cogent Healthcare Inc., Laguna Hills, signed a contract with North Broward Medical Center in Pompano Beach, Fla. Cogent will provide inpatient management services for uninsured patients and for Medicare and Medicaid patients who don’t have a primary care physician on staff at the 409-bed public hospital … Irvine-based Micro Therapeutics Inc. said Natick, Mass.-based Boston Scientific Corp. signed a definitive agreement to buy Foster City-based Enteric Medical Technologies Inc. Micro Therapeutics has a 20% voting stake in Enteric … University of California, Irvine’s Graduate School of Management is still accepting applications for its MBA program for health industry professionals; the deadline is July 15. Information: (949) 824-4622 … Former Olympic gymnast Peter Vidmar will speak on “Keeping Motivated in a Turbulent Industry” at the June 13 meeting of the Orange County Employee Benefit Council, 7:30 to 9:30 a.m., Irvine Marriott, 18000 Von Karman Ave. Information: (714) 573-8605 … Retired NFL star Dick Butkus recently appeared at an event sponsored by St. Joseph Hospital. Butkus, a Los Angeles County resident, talked about his decision to have cardiac surgery at St. Joseph.
