Blue Cross of California & Catholic Healthcare West Resolve Lawsuit Issues Cooperatively; Organizations Agree to Partner On Action Plan Benefiting Members and Patients.Business Editors & Health/Medical Writers SAN FRANCISCO San Francisco (săn frănsĭs`kō), city (1990 pop. 723,959), coextensive with San Francisco co., W Calif., on the tip of a peninsula between the Pacific Ocean and San Francisco Bay, which are connected by the strait known as the Golden and THOUSAND OAKS Thousand Oaks, residential city (1990 pop. 104,352), Ventura co., S Calif., in a farm area; inc. 1964. Avocados, citrus, vegetables, strawberries, and nursery products are grown. , Calif.--(BUSINESS WIRE)-- Feb. 14, 2001 Blue Cross of California, an operating subsidiary An operating subsidiary is a business term frequently used within the United States railroad industry. In the case of a railroad, it refers to a company that is a subsidiary but operates with its own identity and rolling stock. of WellPoint Health Networks (NYSE NYSE See: New York Stock Exchange :WLP WLP WebLogic Portal (Bea Systems) WLP Wafer Level Packaging WLP Women's Learning Partnership (Bethesda, MD) WLP Workplace Learning & Performance WLP World Library Partnership, Inc. ), and non-profit, San Francisco-based Catholic Healthcare West Catholic Healthcare West (CHW) is a California not-for-profit public benefit corporation that operates hospitals in California, Arizona, and Nevada[1]. As such, it is exempt from federal and state income taxes. (CHW CHW Chicago White Sox CHW Catholic Healthcare West CHW Children's Hospital at Westmead (Australia) CHW Children's Hospital of Wisconsin CHW Community Health Worker CHW ChileHardware (Spanish website) ) announced they have reached a mutual agreement to resolve pending litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. issues. In addition, the organizations have established a jointly funded strategic partnership that includes programs and products to benefit CHW patients and Blue Cross members through innovation in the delivery of health-care services. The strategic partnership has been in development since Blue Cross and CHW successfully renewed their contract covering 40 CHW facilities throughout the state and three CHW-affiliated medical groups in Sacramento and Santa Cruz Santa Cruz, city, United States Santa Cruz (săn`tə kr  z), city (1990 pop. 49,040), seat of Santa Cruz co., W Calif., on the north shore of Monterey Bay; inc. 1866. on Aug. 15, 2000.The new strategic partnership will focus on several key areas affecting patient care and health outcomes. Dr. Robert Crocker, senior vice president and medical director for Blue Cross, and Dr. George Bo-Linn, senior vice president and chief medical officer for CHW, have worked closely to build the components of this unique partnership. "We are very excited and pleased to be making this announcement," said Ron Williams
"This collaboration between CHW and Blue Cross illustrates how providers and health plans can dedicate their collective resources toward initiatives designed to enhance quality and create greater efficiency," said Lloyd Dean, president and chief executive officer of CHW. "We are very pleased that our joint commitment not only addresses outstanding legal issues but also positions CHW and Blue Cross as leaders in our mutual commitment to provide high quality, accessible and affordable care to Californians." The Blue Cross/CHW partnership will include the following care coordination care coordination Managed care 1. The brokering of services for Pts to ensure that needs are met and services are not duplicated by the organizations involved in providing care 2. projects:
-- Clinical Information System -- The organizations will collaborate
in the design and implementation of CHW's clinical information
system with the objective of enhancing delivery of care
specifically within CHW facilities. This system will provide
information that can be used by caregivers to directly improve
patient care and health outcomes.
-- Nursing Recruitment and Retention -- In light of the critical
nursing shortage impacting the entire health industry, the
organizations will engage in a collaborative effort to assist in
the recruitment and retention of nurses at CHW facilities. The
program will include forgivable loans for nursing students who
agree to serve at CHW hospitals for a stipulated period following
completion of their training and funding for continuing nursing
education.
-- Patient Safety -- Partnership funding will be used to hire a
number of clinical pharmacists to improve the quality of health
care and patient safety at CHW facilities. They will help ensure
appropriate use of medications to reduce the risk of harmful drug
interactions in patients receiving treatment or care.
-- Electronic Connectivity -- A portion of the partnership investment
by the organizations will be dedicated to enhancing the technology
and related professional services used by Blue Cross and CHW to
improve transmission of claims and other data resulting in more
efficient and accurate transactions.
"This is a major step forward in cooperative partnership planning and execution that has resulted in real actionable items that will impact the quality of care and medical outcomes for our members and CHW's patients," said Crocker. "Following successful contract negotiations to ensure continuity and access to care, this is the optimal type of partnership we are looking to achieve with our network hospitals and physician partners." According to Bo-Linn of CHW: "This partnership and its affiliated actions will provide a more efficient and cooperative working relationship between our two organizations. This is a unique, forward-thinking opportunity that we hope will create both better business and better health care for CHW care givers and those Blue Cross members who trust us for their health-care needs." As part of its resolution with CHW, this partnership will also seek to lower costs of claims and billing transactions while implementing an improved system for claims billing and payment. Blue Cross and CHW will seek to lower both the cost and time of electronic claims transmission and processing. Both organizations will develop better electronic connectivity resulting in real-time eligibility and claim status information, compliance with the electronic standards mandated by the Health Insurance and Portability Accountability Act of 1996 (HIPAA (Health Insurance Portability & Accountability Act of 1996, Public Law 104-191) Also known as the "Kennedy-Kassebaum Act," this U.S. law protects employees' health insurance coverage when they change or lose their jobs (Title I) and provides standards for patient health, ) and a technical forum to continuously enhance electronic connectivity and integration between Blue Cross and CHW. Blue Cross of California, with 5.6 million medical members, is the California operating subsidiary of WellPoint Health Networks Inc., one of the nation's largest publicly traded managed-care companies. WellPoint serves the health-care needs of about 7.9 million medical and approximately 40 million specialty members nationally. WellPoint offers a broad spectrum of quality network-based health products including open access PPO PPO abbr. preferred provider organization PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there , POS (1) See point of sale and packet over SONET. (2) "Parent over shoulder." See digispeak. POS - point of sale and hybrid products, HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, and specialty products. Specialty products include pharmacy benefit management A Pharmacy Benefit Manager (PBM) is a third party administrator of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. , dental, utilization management, vision, mental health, life and disability insurance, long-term-care insurance, flexible spending accounts flexible spending account, n an employee reimbursement account primarily funded with employee-designated salary reductions. Funds are reimbursed to the employee for health care (medical and/or dental), dependent care, and/or legal expenses and are , COBRA administration, and Medicare supplements. Catholic Healthcare West is the largest Catholic health-care system based in the Western United states Noun 1. western United States - the region of the United States lying to the west of the Mississippi River West Santa Fe Trail - a trail that extends from Missouri to New Mexico; an important route for settlers moving west in the 19th century with 47 hospitals and five medical practice groups in California, Arizona and Nevada. CHW is sponsored by nine religious orders and works to further the healing ministry of Jesus According to the Canonical Gospels, the Ministry of Jesus began when Jesus was around 30 years old, and lasted a period of 1-3 years. In the Biblical narrative, Jesus' method of teaching involved parables, metaphor, allegory, sayings, proverbs, and a small number of direct sermons. by delivering compassionate, high-quality, affordable health services health services Managed care The benefits covered under a health contract ; providing direct services to our brothers and sisters who are poor and disenfranchised; advocating on their behalf and partnering with others to improve the quality of life in the communities we serve. CHW annually cares for more than 300,000 patients; provides more than $400 million in community benefits and care for the poor; and employs approximately 40,000 people.
40 CATHOLIC HEALTHCARE WEST HOSPITALS PARTICIPATING IN
BLUE CROSS OF CALIFORNIA'S CARE GIVER NETWORK
Northern California Division:
Mercy General Hospital, Sacramento
Mercy Hospital of Folsom, Folsom
Mercy San Juan Hospital, Carmichael
Methodist Hospital of Sacramento, Sacramento
Sierra Nevada Memorial Hospital, Grass Valley
Woodland Memorial Hospital, Woodland
St. Dominic's Hospital, Manteca
Oak Valley District Hospital, Oakdale
St. Joseph's Medical Center, Stockton
St. Joseph's Behavioral Health Center, Stockton
Mercy Hospital and Health Services, Merced
Mark Twain St. Joseph's Hospital, San Andreas
Greater Bay Area Division:
St. Mary's Medical Center, San Francisco
Seton Medical Center, Daly City
Seton Medical Center Coastside, Moss Beach
O'Connor Hospital, San Jose
St. Louise Regional Hospital, Gilroy
Saint Francis Memorial Hospital, San Francisco
Sequoia Hospital, Redwood City
Dominican Hospital, Santa Cruz
Southern California Area Region:
Robert F. Kennedy Medical Center, Hawthorne
California Hospital Medical Center, Los Angeles
St. Vincent Medical Center, Los Angeles
Glendale Memorial Hospital & Health Center, Glendale
St. Francis Medical Center, Lynwood
St. Mary Medical Center, Long Beach
Northridge Hospital Medical Center, Roscoe Campus
Northridge Hospital Medical Center, Sherman Way Campus
San Gabriel Valley Medical Center, San Gabriel
St. Bernadine Medical Center, San Bernardino
Community Hospital of San Bernardino, San Bernardino
Bakersfield Memorial Hospital, Bakersfield
Mercy Hospital, Bakersfield
Memorial Center, Bakersfield
Mercy Southwest Hospital, Bakersfield
Mercy Westside Hospital, Taft
Marian Medical Center, Santa Maria
St. Francis Medical Center, Santa Barbara
St. John's Pleasant Valley Hospital, Camarillo
St. John's Regional Medical Center, Oxnard
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