CaliforniaCare Health Plans announces results of program to strengthen hospital network.
WOODLAND HILLS, Calif.--(BUSINESS WIRE)--Aug. 30, 1996-- CaliforniaCare Health Plans (CCHP), an affiliate of Blue Cross of California, has completed its hospital recontracting process and announced the final results of its new program, Partnerships for Quality.
The program is designed to develop long-term partnerships with hospitals that demonstrate a commitment to quality, a clear vision of the future and the financial strength to compete in California's market-driven health-coverage environment.
The hospital network recontracting was based on voluntary responses to a Request for Proposal (RFP). Some 370 hospitals, most of which are in the plan's statewide hospital network, participated in the program.
The responses provided information in two basic areas -- 1) data and other statistical information documenting the hospital's commitment to, at a minimum, community standards of quality; and 2) reimbursement rates.
``This program is a viable means of responding to the increasing pressures of the marketplace,'' said Max Brown, senior vice president of network development/management.
``Purchasers and members look to the industry to reduce health- care costs. They also ask the health plans to demonstrate the quality and stability of the provider networks with which they contract.''
Responding hospitals received scores based on the analysis and evaluation of the RFP responses and other quality measures, including clinical outcomes, accreditation from organizations such as the Joint Commission on Accreditation of Healthcare Organizations Joint Commission on Accreditation of Healthcare Organizations,
n.pr the United States body that accredits healthcare organizations.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO/TJC),
n. (JCAHO JCAHO Joint Commission on Accreditation of Healthcare Organizations, see there ), and the hospital's managed-care infrastructure.
To equitably compare financial and reimbursement information, hospitals were grouped into six peer categories. This allowed for a comparison of basically similar institutions with regard to size, scope of services and demographic setting.
Almost all of the responding hospitals have been designated as Tier I or Tier II facilities. Some have been listed as pending, including a few large, multihospital organizations with which discussions are continuing.
Tier I facilities are considered long-term BCC partners and will be given preferred status within the CCHP network. These preferred partners may be eligible for a variety of long-term programs such as joint marketing, electronic interfacing, quality and outcome support and simplified utilization management procedures.
Patients admitted to those institutions will be covered by superior hospital benefits, and the institutions will be prominently featured in CCHP promotional material.
Tier II hospitals will continue to participate in the network. However, many patients will be responsible for higher co-payments at those facilities. Members admitted to hospitals identified as pending will not be subject to higher co-payments at this time. Changes in some benefit plans have been made already to reflect higher co-payments at Tier II hospitals.
The tiering designation is not a quality-of-care distinction. The basis of their designation is the relativity of their proposed rates to other hospitals in their peer category, the extent of the change in their proposed rates from their historical rates and the presence of other comparable hospitals in the same service area.
In some cases, hospitals have been designated Tier II because in their areas BCC found a surplus of hospitals with very similar capabilities.
``We feel that our recontracting effort highlights our commitment to develop a hospital network that is more flexible and provides patients with quality health care at the most cost effective prices,'' said Brown.
``This is a rapidly changing, intensely competitive environment in which we need to respond quickly, effectively and efficiently. For that reason, we will use our Partnerships for Quality program to continuously evaluate our hospitals to stay abreast of their performance and ensure our members that they have the most current, accurate data on their providers.''
CaliforniaCare Health Plans is an affiliate of Blue Cross of California. Together with their affiliates, they offer a comprehensive array of managed-care health plans provided through their health-maintenance organization, preferred-provider organization and specialty managed-health-care networks.
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, vision, mental health, life insurance, Medicare supplement and workers' compensation. -0-
The following hospitals have been designated as Tier hospitals:
Los Angeles County
Barlow Respiratory Hospital Brotman Medical Center Brotman Medical Center (BMC) is a hospital in Culver City, California, USA. History
The hospital was founded in 1924.. On September 1, 2005, Brotman Medical Center changed owners. The new owners are a group led by Prospect Medical Holdings, Inc. California Medical Center Cedars-Sinai Medical Center Cedars-Sinai Medical Center is a world-renowned hospital located in Los Angeles, California. History
Cedars-Sinai is the result of a merger in 1961 between two major Los Angeles hospitals, Cedars of Lebanon and Mount Sinai Home for the Incurables, with Steve Broidy as Centinela Hospital Medical Center Children's Hospital of Los Angeles Community Hospital of Gardena Daniel Freeman Marina Hospital Daniel Freeman Memorial Hospital Good Samaritan Hospital Good Samaritan Hospital may refer to:
In the United States:
In the United Kingdom:
In the United States:
Northwest Los Angeles
Antelope Valley Hospital Medical Center Antelope Valley Hospital Medical Center or simply Antelope Valley Hospital (AVH) is a public hospital located in Lancaster, California. External links
San Fernando Valley San Fernando Valley
Valley, southern California, U.S. Northwest of central Los Angeles, the valley is bounded by the San Gabriel, Santa Susana, and Santa Monica mountains and the Simi Hills.
Encino-Tarzana Regional Medical Center (Encino Campus) Encino-Tarzana Regional Medical Center (Tarzana Campus) Medical Center of North Hollywood Northridge Hospital Medical Center Northridge Hospital Medical Center is a hospital in the Northridge town of Los Angeles, California, USA. It is currently operated by Catholic Healthcare West. History
The hospital was founded in 1955 by Dr. -- Roscoe Northridge Hospital Medical Center -- Sherman Way Providence Holy Cross Medical Center Providence Holy Cross Medical Center is a hospital in Mission Hills, California, USA. The hospital has 254 beds, and is part of Providence Health & Services. History Sherman Oaks Hospital Sherman Oaks Hopital (SOH) is an 153 bed acute care facility in Sherman Oaks, California, USA and is home of world renowned the Grossman Burn Center. SOH is owned and operated by Prime Healthcare Services, Inc. & Health Center Valley Presbyterian Hospital Columbia West Hills Regional Medical Center
San Gabriel Valley The San Gabriel Valley is one of the principal valleys of southern California. It lies to the east of the city of Los Angeles, to the north of the Puente Hills, to the south of the San Gabriel Mountains, and to the west of the Inland Empire.
Beverly Hospital Casa Colina Hospital for Rehabilitative Medicine Citrus Valley Medical Centers -- Inter Community Citrus Valley Medical Centers -- Queen of the Valley City of Hope National Medical Center City of Hope is one of 39 NCI-designated Cancer Centers and is located in the city of Duarte, California. City of Hope comprises an ambulatory and in-patient cancer treatment center as well as a biomedical research facility known as the Beckman Research Institute and the City of Hope Foothill Presbyterian Hospital Garfield Medical Center Glendale Adventist Medical Center Glendale Adventist Medical Center is located in the Los Angeles suburb of Glendale, California. It was founded in 1905. Glendale Adventist Medical Center is a sister institution of Loma Linda University Medical Center and is a part of the Seventh-day Adventist hospital system. Huntington East Valley Hospital Huntington Memorial Hospital Methodist Hospital of Southern California San Dimas Community Hospital San Gabriel Valley Medical Center Santa Teresita Hospital Verdugo Hills Hospital
Avalon Municipal Hospital Lakewood Regional Medical Center Little Company of Mary Hospital Little Company of Mary Hospital may refer to:
“RFK” redirects here. For other uses, see RFK (disambiguation).
For the 2006 film, see Bobby. Medical Center San Pedro Peninsula Hospital St. Mary Medical Center St. Mary Medical Center may refer to:
Anaheim Memorial Hospital Brea Community Hospital Children's Hospital at Mission Children's Hospital of Orange County Chapman General Hospital Coastal Communities Hospital Friendly Hills Regional Medical Center Fountain Valley Regional Hospital Hoag Memorial Hospital Presbyterian Columbia Huntington Beach Hospital & Medical Center La Palma Intercommunity Hospital La Palma Intercommunity Hospital (LPH) is an 141 bed acute care facility in La Palma, California, USA. LPH is owned and operated by Prime Healthcare Services, Inc. (PHS), a hospital management company located in Victorville. PHS was founded in 2001 by Prem Reddy, M.D., F.A.C. Los Alamitos Medical Center Martin Luther Hospital Mission Hospital Regional Medical Center Saddleback Memorial Medical Center Samaritan Medical Center, San Clemente St. Joseph Hospital, Orange St. Jude Medical St. Jude Medical, Inc. NYSE: STJ is a $2.9 billion global cardiovascular device company, with headquarters in St. Paul, Minnesota, United States. The company sells products in more than 100 countries and has over 20 operations and manufacturing facilities worldwide. Center UCI Medical Center -- University of California, Irvine Western Medical Center/Anaheim Western Medical Center/Santa Ana
San Diego County
Alvarado Hospital Medical Center Children's Hospital & Health Center El Centro Regional Medical Center Harbor View Medical Center Paradise Valley Hospital Pioneers Memorial Hospital San Diego Rehabilitation Institute Tri-City Medical Center
San Luis Obispo County
Arroyo Grande Community Hospital French Hospital Medical Center Sierra Vista Regional Medical Center Twin Cities Community Hospital
Santa Barbara County
Goleta Valley Community Hospital Lompoc District Hospital Marian Medical Center Santa Barbara Cottage Hospital Santa Barbara Cottage Hospital is a hospital in the city of Santa Barbara, California. It is owned and operated by Cottage Health Systems.
It is the only Level II trauma center between Los Angeles (south) and the Bay Area (north) on coastal California. Santa Ynez Valley Hospital Inc. St. Francis Medical Center St. Francis Medical Center may refer to:
San Bernardino County
Ballard Rehabilitation Hospital Barstow Community Hospital Bear Valley Community Hospital Chino Valley Medical Center Chino Valley Medical Center (CVMC) is a 126 bed acute care facility in Chino, California. CVMC is owned and operated by Prime Healthcare Services, Inc. (PHS), an innovative and rapidly expanding hospital management company in Victorville, California. Desert Valley Hospital Hi-Desert Medical Center Loma Linda Community Hospital Loma Linda University Medical Center Loma Linda University Medical Center (LLUMC) is a teaching hospital of Loma Linda University School of Medicine in Loma Linda, California, United States. LLUMC is home to the Venom E.R, which specializes in snake bites. Mountains Community Hospital Needles-Desert Communities Hospital Redlands Community Hospital San Antonio Community Hospital San Antonio Community Hospital (SACH) is an acute, full service medical center in the city of Upland, California. The 283 bed facility is known for its advanced Neo-Natal Intensive Care Unit (NICU) and for its cardiac care programs. Saint Mary Desert Valley Hospital St. Bernardine Medical Center U.S. FamilyCare Medical Center
Los Robles Regional Medical Center Mercy Healthcare Ventura County -- St. John's Pleasant Valley Hospital St. John's Pleasant Valley Hospital is a hospital in Camarillo, California, USA. It is currently operated by Catholic Healthcare West. History
The hospital was founded in 1974. Mercy Healthcare Ventura County -- St. John's Regional Medical Center St. John's Regional Medical Center may refer to:
In the United States:
Bakersfield Memorial Hospital Delano Regional Medical Center Healthsouth Bakersfield Rehab Hospital Kern Valley Hospital District Mercy Healthcare Bakersfield Ridgecrest Community Hospital San Joaquin Community Hospital Tehachapi Hospital West Side District Hospital
El Centro Regional Medical Center Pioneers Memorial Hospital
Corona Regional Medical Center Eisenhower Memorial Hospital Hemet Valley Medical Center Inland Valley Regional Medical Center John F. Kennedy Memorial Hospital Menifee Valley Medical Center Moreno Valley Community Hospital Palo Verde Hospital Parkview Community Hospital Medical Center Riverside Community Hospital San Gorgonio Memorial Hospital
Alta Hospital District Central California Rehabilitation Hospital Chowchilla District Memorial Hospital Coalinga Regional Medical Center Corcoran District Hospital Dameron Hospital Doctors Hospital of Manteca Doctors Medical Center of Modesto Emanuel Medical Center Fresno Surgery Center George L. Mee Memorial Hospital Hanford Community Medical Center Hazel Hawkins Memorial Hospital Kaweah Delta District Hospital Lindsay Hospital Medical Center Lodi Memorial Hospital Madera Community Hospital Mammoth Hospital Memorial Hospital of Los Banos Memorial Hospital of Ceres Memorial Hospital/Medical Center Merced Community Medical Center Mercy Hospital and Health Services Natividad Medical Center Northern Inyo Hospital Saint Agnes Medical Center San Joaquin Valley Rehabilitation Hospital Sanger General Hospital Selma District Hospital Sierra Kings District Hospital Southern Inyo Hospital St. Dominic's Hospital St. Joseph's Medical Center of Stockton Tulare District Hospital Valley Children's Hospital Visalia Community Hospital
Alameda Hospital Alexian Bros. Hospital Alta Bates Medical Center Barton Memorial Hospital Biggs-Gridley Memorial Hospital Brookside Hospital Children's Hospital -- Oakland Chinese Hospital Columbia Good Samaritan Hospital of Santa Clara Valley Columbia San Jose Medical Center Columbia South Valley Hospital Colusa Community Hospital Community Hospital Sonoma County Davies Medical Center Doctors Hospital of Pinole Dominican Santa Cruz Hospital Eastern Plumas District Hospital Eden Hospital/Medical Center Enloe Hospital Feather River Hospital Frank R. Howard Memorial Hospital Fremont Medical Center Glenn Medical Center Golden State Rehabilitation Hospital Healdsburg General Hospital Indian Valley Hospital John C. Fremont Hospital John Muir Medical Center Kentfield Rehabilitation Hospital Lassen Community Hospital Laurel Grove Hospital Lucille Salter Packard Children's Hospital Mark Twain Saint Joseph's Hospital Marshall Hospital Mayers Memorial Hospital Mendocino Coast District Hospital Mercy American River Hospital Mercy General Hospital Mercy Hospital of Folsom Mercy Medical Center -- Mount Shasta Mercy Medical Center -- Redding Mercy San Juan Hospital Methodist Hospital of Sacramento Methodist Hospital is a hospital located in the southern part of Sacramento, California. It is located just off of Highway 99 by taking the Calvine Road/Consumnes River Boulevard exit 289. Its address is 7500 Hospital Drive. The hospital has 162 acute care beds. Modoc Medical Center Mount Diablo Medical Center North Coast Rehabilitation Center O'Connor Hospital Pacific Coast Hospital Palm Drive Hospital Petaluma Valley Hospital Plumas District Hospital Queen of the Valley Hospital Redbud Community Hospital Redding Specialty Hospital Redwood Memorial Hospital Rideout Memorial Hospital Saint Elizabeth Community Hospital Saint Francis Memorial Hospital Saint Francis Memorial Hospital (SFMH) is a hospital in San Francisco, California, USA. It is currently operated by Catholic Healthcare West. History
Founded just over a century ago in San Francisco by five physicians, they undertook to build "the most up-to-date modern Saint Helena Hospital & Health Center Saint Joseph Hospital -- Eureka Saint Louise Hospital Saint Mary's Hospital & Medical Center San Leandro Hospital San Ramon Regional Medical Center Santa Rosa Memorial Hospital Seneca District Hospital Sequoia Hospital Seton Medical Center Seton Medical Center -- Coastside Sierra Nevada Memorial Hospital Sierra Valley District Hospital Siskiyou General Hospital St. Luke's Hospital St. Rose Hospital Sonoma Valley Hospital Sonora Community Hospital Southern Humboldt Community Hospital Stanford University Hospital Summit Medical Center Surprise Valley Community Hospital Tahoe Forest Hospital District Trinity Hospital UC Davis Medical Center The UC Davis Medical Center is a major research hospital located in Sacramento, California and is the primary teaching hospital of UC Davis School of Medicine. Researchers and specialists at the 577 licensed bed medical center work in over 150 areas of specialty. UCSF Medical Center UC San Francisco/Mount Zion Ukiah Valley Medical Center Vencor Hospital -- San Leandro Vencor -- Sacramento Watsonville Community Hospital Woodland Memorial Hospital
The following Tier II hospitals represent about 15 percent of the network:
Los Angeles County
Bellflower Medical Center Century City Hospital Coast Plaza Doctors Hospital Community & Mission Hospitals of Huntington Park Hollywood Community Hospital Medical Center Inc. Los Angeles Community Hospital Midway Hospital Monterey Park Hospital Orthopaedic Hospital Pacific Alliance Medical Center Inc. Santa Marta Hospital Suburban Medical Center Washington Medical Center -- L.A.
Northwest Los Angeles
Lancaster Community Hospital
San Fernando Valley
Granada Hills Community Hospital Pacifica Hospital of the Valley Thompson Memorial Medical Center
San Gabriel Valley
Alhambra Hospital Baldwin Park Hospital Covina Valley Community Hospital Doctors Hospital of West Covina Glendale Memorial Hospital and Health Center Greater El Monte Community Hospital Pomona Valley Hospital and Medical Center St. Luke Medical Center
Bay Harbor Hospital Inc. Pacific Hospital of Long Beach South Bay Hospital Woodruff Community Hospital
Anaheim General Hospital Buena Park Medical Center Columbia West Anaheim Medical Center Garden Grove Hospital and Medical Center Irvine Medical Center Placentia Linda Community Hospital Santa Ana Hospital Medical Center/Doctors Hospital of Santa Ana South Coast Medical Center
San Diego County
Continental Rehabilitation Hospital Mission Bay Hospital
Santa Barbara County
Rehabilitation Institute at Santa Barbara
San Bernardino County
Community Hospital of San Bernardino Victor Valley Community Hospital
Community Memorial Hospital of San Buena Ventura Westlake Medical Center
Kern Medical Center
Bloss Memorial District Hospital Central Valley General Hospital Del Puerto Hospital Dos Palos Memorial Hospital Inc. Kingsburg Medical Center
Chico Community Hospital Community Hospital & Rehab Center of Los Gatos Mad River Community Hospital North Bay Medical Center Redding Medical Center Santa Clara Valley Medical Center Tuolumne General Hospital VacaValley Hospital
The following hospitals are still in negotiations:
California Pacific Medical Center California Pacific Medical Center (CPMC) is one of the largest private, not-for-profit, academic medical centers in Northern California. The Medical Center is a combination of three of San Francisco's oldest medical institutions: Pacific Presbyterian Hospital, Children's Hospital -- California California Pacific Medical Center -- Pacific Clovis Community Hospital Community Hospital of Monterey Peninsula Delta Memorial Hospital El Camino Hospital Fallbrook Hospital District Fresno Community Hospital and Medical Center General Hospital Green Hospital of Scripps Clinic Grossmont District Hospital Marin General Hospital Mercy Healthcare San Diego Mills Peninsula Hospital Novato Community Hospital Oak Valley District Hospital Oroville Hospital & Medical Center Palomar Medical Center Peninsula Hospital & Medical Center Pomerado Hospital Recovery Inn of Menlo Park Salinas Valley Memorial Hospital The Salinas Valley Memorial Hospital is a public district hospital in Salinas, California. With 269 hospital beds and 2,132 employees, the hospital has tried to improve the health of the Salinas Valley by using the latest healthcare technology. Scripps Memorial Hospital -- Chula Vista Scripps Memorial Hospital -- East County Scripps Memorial Hospital -- Encinitas Scripps Memorial Hospital -- La Jolla Sharp Cabrillo Hospital Sharp Chula Vista Medical Center Sharp Coronado Medical Center Sharp HealthCare Murrieta Sharp Memorial Hospital Sierra Community Hospital Sierra View District Hospital Sierra View District Hospital is a 163-bed, full-service acute care facility located in Porterville, California. Founded in 1958, the hospital serves the Southern Sequoia region of California’s Central Valley. Sutter Amador Hospital Sutter Auburn Faith Hospital Sutter Coast Hospital Sutter Davis Hospital Sutter General Hospital Sutter Lakeside Hospital Sutter Memorial Hospital Sutter Roseville Medical Center Sutter Solano Medical Center Tracy Community Memorial Hospital University of California -- San Diego Medical Center Valley Memorial Hospital ValleyCare Medical Center Washington Hospital
CONTACT: CaliforniaCare Health Plans, Woodland Hills
Elise Anderson, 818/703-2703