OF THE FIGHT FOR A NEW CALIFORNIA LAW. MORE THAN 16,000 PEOPLE IN YOLO COUNTY CAN’T GO TO THE DOCTOR RIGHT NOW. THEY’RE STUCK IN LIMBO WITH NO IDEA WHEN THEY CAN GET MEDICAL HELP. THANKS FOR JOINING US AT 4:00. I’M LISA GONZALEZ AND I’M TY STEELE. THIS ALL STEMS FROM A RECENTLY EXPIRED CONTRACT BETWEEN A MAJOR HEALTH CARE SYSTEM AND A MEDI-CAL BENEFITS ADMINISTERED SUTTER KCRA 3’S ORKO MANNA EXPLAINS WHY NEGOTIATIONS ARE AT A STANDSTILL RIGHT NOW, AND HOW THE COUNTY IS NOW STEPPING IN. MEDICAL COVERAGE CHAOS AFFECTING THOUSANDS IN YOLO COUNTY. IN OUR 30 YEARS, WE’VE NEVER HAD A CONTRACT EXPIRED. PARTNERSHIP HEALTH PLAN OF CALIFORNIA IS RESPONSIBLE FOR MEDI-CAL BENEFITS. GETTING TO 900,000 LOW INCOME CALIFORNIANS. BUT BECAUSE THEIR CONTRACT WITH DIGNITY. HEALTH EXPIRED ON MARCH 31ST, MORE THAN 16,000 PEOPLE IN YOLO COUNTY DO NOT HAVE ACCESS TO A PRIMARY CARE PHYSICIAN RIGHT NOW, MEANING CANCELED DOCTORS APPOINTMENTS TO THE MEDI-CAL. WE ARE REALLY FIXED IN TERMS OF OUR COSTS. THAT’S PARTNERSHIP HEALTH PLANS MAIN STICKING POINT SAYING DIGNITY HEALTH IS ASKING FOR HIGH RATES THAT GO BEYOND THEIR BUDGET, WHICH IS FUNDED BY TAXPAYERS. THE MONEY THAT THEY’RE ASKING OF PARTNERSHIP FOR COSTS SUCH AS MEDICAL CARE IN THE HOSPITAL BILL, A VISIT TO SEE A DOCTOR, A SURGERY, FOR EXAMPLE, THE RATES THAT THEY WANT FOR THOSE SERVICES FAR EXCEED MEDI-CAL ALLOWABLE RATES. DIGNITY HEALTH SAYS THEY KNOW THE SERVICES THEY PROVIDE AT THEIR FACILITIES LIKE THIS ONE ARE IMPORTANT FOR PATIENTS. SO WE ASKED THEM TO RESPOND TO PARTNERSHIP HEALTH PLAN OF CALIFORNIA’S COMMENT, SAYING THE HEALTH SYSTEM IS ASKING FOR TOO MUCH. WE KNOW THAT. AND YOU KNOW THAT INFLATION HAS GONE UP SIGNIFICANTLY. AND SO WHAT WE’RE ASKING FOR PARTNERSHIP IS A FAIR APPROACH TO HELP US MEET OUR COSTS AND TO HELP US HAVE THE FUNDS WE NEED TO CONTINUE TO PROVIDE THE SERVICES, RECRUIT AND RETAIN THE PROFESSIONALS WE NEED TO SERVE OUR COMMUNITIES. ARE WE AT A STANDSTILL RIGHT NOW IN TERMS OF NEITHER SIDE REALLY BUDGING, OR WHAT WILL IT TAKE FOR THERE TO BE A NEW AGREEMENT? WE NEED PARTNERSHIP TO COME TO THE TABLE, READY TO NEGOTIATE FAIRLY, RECOGNIZING THAT WE NEED ANNUAL INCREASES TO OFFSET OUR COSTS. WE KEEP THE CONVERSATIONS GOING, ALWAYS MULTIPLE TIMES A DAY, BACK AND FORTH. THE YOLO COUNTY BOARD OF SUPERVISORS IS ALSO TRYING TO SPEED UP THE PROCESS. THEY SIGNED THIS LETTER SAYING IN PART, QUOTE, BOTH PARTIES MUST RECOGNIZE THEIR SHARED RESPONSIBILITY TO UPHOLD THE WELL-BEING OF THE POPULATION THEY SERVE. AND THEY’VE SENT MESSAGES TO LAWMAKERS AND STATE LEADERS TO HELP MAKE SURE THEY’RE ALSO PUTTING SOME PRESSURE ON DIGNITY AND PARTNERSHIP TO GET THESE NEGOTIATIONS GOING AGAIN. AND TO WORK ON SIGNING A CONTRACT. REPORTING IN YOLO COUNTY, ORKO MANNA KCRA THREE NEWS AND FOR PATIENT UPDATES AND MORE INFORMATION ON WHAT YOU CAN DO IF YOU’RE BEING IMPACTED BY THIS,
16,000 Yolo County residents without health coverage amid stalled negotiations
The issue stems from a contract between Dignity Health and Partnership HealthPlan that expired on March 31.
Updated: 4:44 PM PDT Apr 12, 2024
Thousands of people in Yolo County cannot see a primary care physician right now because of an expired contract between Dignity Health and Partnership HealthPlan of California.Partnership HealthPlan of California is a nonprofit health care organization that administers Medi-Cal benefits to 900,000 low-income Californians across 24 counties. But because their contract with the Dignity Health system expired on March 31, 2024, more than 16,000 people in Yolo County cannot see a doctor, or their current doctor’s appointments are being canceled.Katherine Barresi, chief health services officer of Partnership HealthPlan, said their main sticking point is that they are fixed in terms of their costs. She added that Dignity Health is asking for rates that go beyond Partnership HealthPlan’s budget.“Unfortunately, Dignity is asking for very high rates. And we’re a Medi-Cal managed care plan, and what that means is, Medi-Cal comes from taxpayers. We’re funded by the state and federal budgets, and so we have a budget to work within and to use,” Barresi said. “The money they’re asking of Partnership for costs, such as medical care in the hospital, a visit to see a doctor, a surgery, for example, the rates that they want for those services far exceed Medi-Cal allowable rates and even far exceed rates that Partnership has had in place with them for quite some time.”But Dignity Health Medical Foundation CEO Robert Quinn said Partnership HealthPlan needs to cover more of the cost.“We know that right now, what Partnership pays us does not cover our actual costs of providing the care we need to. We know that, and you know that, inflation has gone up significantly, and so what we’re asking for Partnership is a fair approach to help us meet our costs and to help us have the funds we need to continue to provide the services, recruit and retain the professionals we need to serve our communities,” Quinn said.Talks at an impasseKCRA 3’s Orko Manna asked, “Are we at a standstill right now, in terms of neither side really budging? Or what will it take for there to be a new agreement?”“We need Partnership to come to the table, ready to negotiate fairly, recognizing that we need annual increases to offset our costs,” Quinn responded.Dignity Health clarified with KCRA 3 in an email statement.“While we are communicating with Partnership regularly to ensure continuity of care for members, they currently have not resumed negotiations with us,” the statement said. But Barresi said Partnership HealthPlan has “not stopped” talking with Dignity Health.“We keep the conversations going always, multiple times a day, back and forth. We’re very eager and really hope that Dignity continues to meet us at the table, so that we can return covering services for the safety net communities that we serve,” Barresi said.The Yolo County Board of Supervisors is also trying to speed up the process. They signed a letter this week which said, in part, “A mutually beneficial agreement is imperative in this situation. Both parties must recognize their shared responsibility to uphold the wellbeing of the population they serve… Time is of the essence, and prompt action is necessary to prevent further disruptions to healthcare services in our community.”Board Chair Lucas Frerichs also said they have reached out to state leaders for assistance.“We have been doing a number of things, including sending a letter to Secretary Mark Ghaly, so the Health and Human Services Division of the State of California. We’ve also been talking to our state assembly member and senator, as well as our member of Congress, and really trying to enlist their help as well… to help make sure we are also putting some pressure on Dignity and Partnership to get these negotiations going again, and work on signing a contract,” Frerichs said.Coverage hasn’t stopped for all membersIn the meantime, both Dignity Health and Partnership HealthPlan are working to help patients in need. Quinn said patients who need continuity of care will continue to get the services they need.“It is our mission to serve the most vulnerable, and we will continue to do so,” Quinn said. “The intent is to make sure that people who have conditions that are inflight, or actively being treated, don’t have that interrupted, so examples would be pregnant women, children under three years old, people undergoing active cancer treatment.”Barresi also said Partnership HealthPlan prioritizes giving their members access to medical care and services, so they are helping patients navigate new doctor’s offices and visits.“They were placed in a direct member category here the health plan, which gave them choice and option to move around our network and in Yolo County, and then if they didn’t call us or didn’t go onto our member portal to say, ‘Hey, this is the provider I want for May 1, they are going to be issued and sent new cards May 1 to say, ‘Here’s where you can go locally for care,’” Barresi said.Other counties that are impactedYolo County is not the only county with residents who are being affected by the expired contract. Here are the others, according to Partnership HealthPlan:Nevada County: Just over 900 residentsShasta County: Just under 4,000 residentsSiskiyou County: Just over 1,700 residentsTehama County: Just over 8,800 residentsAs of Friday evening, it is still unclear when an agreement could be reached between Dignity Health and Partnership HealthPlan.To find out more about what to do if you are impacted, click here.
Thousands of people in Yolo County cannot see a primary care physician right now because of an expired contract between Dignity Health and Partnership HealthPlan of California.
Partnership HealthPlan of California is a nonprofit health care organization that administers Medi-Cal benefits to 900,000 low-income Californians across 24 counties. But because their contract with the Dignity Health system expired on March 31, 2024, more than 16,000 people in Yolo County cannot see a doctor, or their current doctor’s appointments are being canceled.
Katherine Barresi, chief health services officer of Partnership HealthPlan, said their main sticking point is that they are fixed in terms of their costs. She added that Dignity Health is asking for rates that go beyond Partnership HealthPlan’s budget.
“Unfortunately, Dignity is asking for very high rates. And we’re a Medi-Cal managed care plan, and what that means is, Medi-Cal comes from taxpayers. We’re funded by the state and federal budgets, and so we have a budget to work within and to use,” Barresi said. “The money they’re asking of Partnership for costs, such as medical care in the hospital, a visit to see a doctor, a surgery, for example, the rates that they want for those services far exceed Medi-Cal allowable rates and even far exceed rates that Partnership has had in place with them for quite some time.”
But Dignity Health Medical Foundation CEO Robert Quinn said Partnership HealthPlan needs to cover more of the cost.
“We know that right now, what Partnership pays us does not cover our actual costs of providing the care we need to. We know that, and you know that, inflation has gone up significantly, and so what we’re asking for Partnership is a fair approach to help us meet our costs and to help us have the funds we need to continue to provide the services, recruit and retain the professionals we need to serve our communities,” Quinn said.
Talks at an impasse
KCRA 3’s Orko Manna asked, “Are we at a standstill right now, in terms of neither side really budging? Or what will it take for there to be a new agreement?”
“We need Partnership to come to the table, ready to negotiate fairly, recognizing that we need annual increases to offset our costs,” Quinn responded.
Dignity Health clarified with KCRA 3 in an email statement.
“While we are communicating with Partnership regularly to ensure continuity of care for members, they currently have not resumed negotiations with us,” the statement said.
But Barresi said Partnership HealthPlan has “not stopped” talking with Dignity Health.
“We keep the conversations going always, multiple times a day, back and forth. We’re very eager and really hope that Dignity continues to meet us at the table, so that we can return covering services for the safety net communities that we serve,” Barresi said.
The Yolo County Board of Supervisors is also trying to speed up the process. They signed a letter this week which said, in part, “A mutually beneficial agreement is imperative in this situation. Both parties must recognize their shared responsibility to uphold the wellbeing of the population they serve… Time is of the essence, and prompt action is necessary to prevent further disruptions to healthcare services in our community.”
Board Chair Lucas Frerichs also said they have reached out to state leaders for assistance.
“We have been doing a number of things, including sending a letter to Secretary Mark Ghaly, so the Health and Human Services Division of the State of California. We’ve also been talking to our state assembly member and senator, as well as our member of Congress, and really trying to enlist their help as well… to help make sure we are also putting some pressure on Dignity and Partnership to get these negotiations going again, and work on signing a contract,” Frerichs said.
Coverage hasn’t stopped for all members
In the meantime, both Dignity Health and Partnership HealthPlan are working to help patients in need. Quinn said patients who need continuity of care will continue to get the services they need.
“It is our mission to serve the most vulnerable, and we will continue to do so,” Quinn said. “The intent is to make sure that people who have conditions that are inflight, or actively being treated, don’t have that interrupted, so examples would be pregnant women, children under three years old, people undergoing active cancer treatment.”
Barresi also said Partnership HealthPlan prioritizes giving their members access to medical care and services, so they are helping patients navigate new doctor’s offices and visits.
“They were placed in a direct member category here the health plan, which gave them choice and option to move around our network and in Yolo County, and then if they didn’t call us or didn’t go onto our member portal to say, ‘Hey, this is the provider I want for May 1, they are going to be issued and sent new cards May 1 to say, ‘Here’s where you can go locally for care,’” Barresi said.
Other counties that are impacted
Yolo County is not the only county with residents who are being affected by the expired contract. Here are the others, according to Partnership HealthPlan:
- Nevada County: Just over 900 residents
- Shasta County: Just under 4,000 residents
- Siskiyou County: Just over 1,700 residents
- Tehama County: Just over 8,800 residents
As of Friday evening, it is still unclear when an agreement could be reached between Dignity Health and Partnership HealthPlan.
To find out more about what to do if you are impacted, click here.
