Maintain Access to Local Healthcare

Maintain Access to Local Healthcare

 

If you live on the island of Alameda, chances are you’ve thought about what to do if an emergency happens to you or your loved ones, especially in an earthquake which may restrict your ability to travel. When minutes and seconds count, it’s good to know that emergency services exist on the island and that you’re not at risk waiting in traffic to access a hospital outside of Alameda. It might be even more comforting to know that these services are provided by skilled physicians, nurses and staff; many who live on the island and care deeply about their friends and neighbors. 

Ensuring the availability of emergency services and ongoing sustainability of Alameda Hospital was a key concern for establishing the parcel tax in 2002. Alameda Hospital has continued to provide a consistent level of emergency services along with many other programs that are important for the health of the community. 

What you might not know is that, for many years, the payments that health plans made to Alameda Hospital for rendering vital services have been far below the cost to provide the care. These health plans continued to charge their members market-based premiums while area employers and Alameda Hospital were, in effect, subsidizing their profits. This caused the hospital to operate unprofitably. The result was a transfer of community funding to health plans; most of which are for-profit. This is a situation that can no longer continue. 

In mid-2015, Alameda Health System (AHS) sent notices to the commercial health plans to negotiate fair reimbursement for services. Many, including HealthNet, United and Kaiser responded favorably in order to provide their Alameda-based members with a local choice for health care. A few plans have yet to respond, including Aetna, Anthem Blue Cross and Blue Shield; perhaps due to their focus on corporate mergers and acquisitions that are occurring. We continue efforts to gain their attention and are cautiously optimistic we will reach agreement for Alameda Hospital to participate in their networks to benefit their local members.

We also understand that the remaining negotiations have affected the members with these plans who wish to choose Alameda Hospital for their health-care needs. Although we had hoped for timely resolution to avoid confusion over access to local services, we understand the frustration by those who have not been able to obtain a clear response on options from their plans. Please know, however, your PPO plan benefits do provide you with options to use Alameda Hospital, and you can call 814-4641 for information to help you make informed decisions about your care.

First, let me set the record straight despite what you may have read or heard — Medicare members are not affected. There are no restrictions to Medicare members on plan network participation regardless of what insurance company provides your supplemental plan. In fact, you are allowed by law to seek treatment from the nearest emergency department regardless of whether the hospital is contracted with your plan or not.

To address questions from our community, we are launching a webpage where you can check the status of your plan with our hospital and locate the phone number to speak with our representatives. We are also developing a list of participating plans, including Medicare supplemental plans, along with the contact number to distribute throughout our community. 

I mentioned the parcel tax and support of Alameda Hospital earlier. I want to thank those who understand the importance of maintaining emergency services on the island which is what the parcel tax was largely established to protect. Second, let me remind all readers that these dollars remain on the island to support Alameda Hospital in meeting your emergency needs as well as reinvest in expanded services, new equipment and facility renovation.

Finally, I want to close by reminding readers that Alameda Hospital contributes to the economic health of the island community. The support of local businesses by our more than 600 employees is critical to the economic vibrancy of this community. Many of these employees live and work on the island and support local taxes that sustain critical community infrastructure including fire, police and emergency medical services. 

The good news is that Alameda Hospital is much stronger today than when it joined AHS in May 2014 thanks to ongoing efforts by AHS to ensure the hospital remains open to serve the community, including good contracts with many commercial plans providing full access to local services. We are meeting the vision set forward by our district board to strengthen the hospital, ensure continued health care for area residents and preserve the jobs of your friends and neighbors. Our people are here 24/7 to care for you; often when you least expect to need our services. We’re honored to be the choice of health care for so many residents, and look forward to serving you in the future. 

 

Bonnie Panlasigui is the chief administrative officer at Alameda Hospital. You may reach her at bpanlasigui @alamedahealthsystem.org.