HomeMy WebLinkAboutMINUTES - 04012003 - D2 tontra
TO: BOARD OF SUPERVISORS v V'
FROM: William B. Walker, M.D. 00%
Gos a
DATE: April 1, 200
SUBJECT: Tenet Corporation County
SPECIFIC REQUEST(S)OR RECOMMENOAT#ON(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
Accept report from the Health Services Director.
BACKGROUND:
During the March 25, 2003 meeting the Board requested that the Health Services
Director provide additional information concerning the cancellation of the contract
with the Tenet Corporation (Doctors Hospital of San Pablo).
The Contra Costa Health Plan has contracted with Doctors' Medical Center since
1994 for the provision of inpatient services to enrollees of the Contra Costa
Health Plan (CCHP). A chronology of the contract and contract negotiations
follows:
• Original contract was executed with Brookside Hospital in September 1994.
• Contract was assigned to Tenet HealthSystem Hospitals, Inc. when Tenet
leased the facility and operations from the West County Hospital District in
November 1996.
• Rates were renegotiated in 1998 and the resulting rate increases became
effective in January 1999.
CCHP notified Tenet in December 2002 that stop loss claims had become
unacceptably high and offered an alternative rate proposal. It should be noted that
the stop loss contract provision was included to protect the hospital from unusual
or extraordinary losses resulting from heavy care patients. Stop loss rates are
CONTINUED ON ATTACHMENT: ,,,k=__"#^S SIGNATURE:
-,*COMMENDATION OF COUNTY ADMINISTRATOR
___,RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S): y
� ._...._
. _ --------- ----------------------------------� --
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ACTION OF BOA �t N A P 1L 1 y 2aQ_1_ APPROVE AS RECOMMENDED „_ OTHER
VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
X UNANIMOUS(ABSENT_NONE ) AND ENTERED ON THE MINUTES OF THE
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN.
ABSENT: ABSTAIN:
DISTRICT III SEAT VACANT ATTESTEDAPRIL 1, 2003
CONTACT: Patrick GodWyJ370-5005 JOHN SWEETEN,CLERK OF THE
BOARD OF SUPERVISORS AND
CC: Health Services
COUNTY ADMINISTRATOR
Health Parr
si
BY ./ F f E a� DEPUTY
"triggered"when hospital charges exceed a pre-defined level. Hospitals
that aggressively increase their charges can influence the frequency and
amount of payments under the stop loss provision negating its original
intent and purpose i.e. rather than payment for just heavy care patients it
effectively becomes a payment for all patients.
• After receiving a letter with no counterproposal, CCHP notified Tenet on
January 14, 2003 that unless negotiations could produce an acceptable
rate agreement, without a stop loss provision, the contract would terminate
on March 15, 2003.
• Negotiations were conducted with the Tenet regional office in San Ramon
in January and February and CCHP received the last and final proposal
from Tenet on March 12. No local negotiations directly with Doctors'
Medical Center administration have occurred.
• The last Tenet proposal offered two unacceptable options: one had rates
for Medi-Cal members that were 50% to 80% higher than comparable
Medi-Cal fee-=for-service rates; the other had acceptable daily rates but
required stop loss payments that were more than 350% higher than
comparable Medi-Cal fee-for-service rates
• The contract terminated on March 15, 2003.
• A contract is not needed to insure patient access. Contra Costa Health
Plan members access care throughout the area and the nation at hospitals
with which CCHP has no contract.
• CCHP, based on discussions with staff from Tenet, has no reason to
believe that access to services at Doctors' Medical Center will be adversely
affected by the contract termination. Over 97% of all CCHP admissions to
Doctors Hospital are emergency in nature and admissions for this category
of patients is dictated as a matter of law. The only significant change
between the County and Doctors Hospital will be in the rate of pay.
FISCAL IMPACT:
The contract cancellation will result in savings and cost avoidance in the
$500,000 to $1,000,000 range.
ADDENDUM TO ITEM D.2
Aprill, 2003
On this day the Board of Supervisors considered approving and authorizing the Health
Services Director to terminate the contract with Tenet Healthsystern Hospital, Inc.
(formerly Brookside Hospital).
Dr. William B. Walker,Health Services Director presented the report.
The following member of the public presented testimony:
Joseph Schuman, 2000 Franklin, Oakland, (California Nurses Association).
The Board discussed the matter, and Supervisor Glover moved to make the following
recommendations,which was seconded by Supervisor Gioia:
• APPROVED and AUTHORIZED the Health Services Director to terminate the
contract with Tenet Healthsystern Hospital, Inc. (formerly Brookside Hospital)
relating to inpatient hospital services for Contra Costa Health Plan members
effective at the close of business on March 15, 2003;
• RATIFIED the actions of the Health Services Department in issuing a 60-day
advance written notice to the contractor;
• And DIRECTED Health Services to immediately issue a press release announcing
Tenet is to continue receiving patients in compliance with state mandate.
After further discussions, the vote on the motion was as follows:
AYES: Supervisors Gioia,Uilkema, Glover, and DeSaulnier
NOES: None
ABSENT: None
ABSTAIN: None
DISTRICT III SEAT VACANT
The motion passed.
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