John Muir and UCSF Expand Network to Form Canopy Health

John Muir and UCSF Expand Network to Form Canopy Health

August 8, 2016 | VOLUME 23 | NUMBER 31 TOP STORIES John Muir and UCSF Expand Published Monday, California Healthfax is Network to Form Canopy Health copyrighted by HealthLeaders Media, a division of BLR, 35 Village Road, Suite 200, Middleton, Health plan to launch this fall with Health Net MA 01949 and is transmitted solely to the sub- scriber. Any unauthorized copying, duplication or The Bay Area Accountable Care Network established by John Muir Health transmission is strictly prohibited. Subscriptions and UCSF Health has added seven new hospitals to its network and changed its are $179 for 48 issues. For group and bulk sub- name to Canopy Health as it prepares to launch this fall. scriptions, call 800-650-6787. Canopy Health also added three new medical groups to its network to bolster a provider base that now includes more than 4,000 physicians. “We’ve CUSTOMER SERVICE CENTER made significant strides in a short amount of time as we work to provide Bay Email Subscribers: If you do not receive your copy of HealthFax, Area residents with an option to choose Canopy Health during open enrollment in send a request to: [email protected]. the fall of 2016,” said Canopy Health CEO Joel Criste. For renewals or other subscription questions, As part of its expansion, Canopy Health added Marin General Hospital, please call: 800-650-6787. By fax: 866-592-7573. Sonoma Valley Hospital, San Ramon Regional Medical Center, Washington By email: [email protected] Hospital Healthcare System, Alameda Hospital, Highland Hospital, and San Leandro Hospital. Medical groups joining the network are Hill Physicians EDITORIAL SUBMISSIONS Medical Group, which has more than 2,250 physicians in the Bay Area, the John To submit an item for consideration, con- Muir Physician Network, and Meritage Medical Network. tact Doug Desjardins, Editor. By email: [email protected]. By phone: 760-696-3931. The addition of three new medical groups expands the provider base to For other questions, contact Erika Bryan, Managing more than 4,000 physicians and the addition of seven hospitals increases the Editor. By phone: 781-639-1872, ext. 3194. number of hospitals in the Canopy Health provider network to 12 hospitals. The By email: [email protected] network also includes two John Muir hospitals in Concord and Walnut Creek and three UC San Francisco hospitals. ADVERTISING OPPORTUNITIES “We have a lot of independent, like-minded providers who have come To advertise in California Healthfax, together under this strategy, and we all want to provide the appropriate care in please contact Susan Pesaturo: By email: [email protected] the right setting at the right time,” said Michael Moody, senior vice president of By phone: 978-624-4594 partnership, integration, and development for John Muir Health. Canopy Health received its limited Knox-Keene license from the state Department of Managed Health Care on August 3. The license allows it to pro- vide services in San Francisco, Alameda, Marin, and Contra Costa counties and in portions of Sonoma, Solano, and San Mateo counties. « CONTINUED ON PAGE 2 » TO SEE ADDITIONAL JOB OPPORTUNITIES SEARCH NOW — please visit CA Jobs online at — PAGE 2 WWW.HEALTHLEADERSMEDIA.COM/CALIFORNIA-JOBS For subscription services, call 800-753-0131 August 8, 2016 IN BRIEF TOP STORIES CONTINUED FROM PAGE 1 John Muir and UCSF Expand cont. ° The United States Courts for the Ninth Circuit has ruled that Dignity Criste said Canopy Health is different from health plans launched by other Health's pension plan is subject to health systems. “Our model is unique, as we are partnering with health plans to the requirements of the Employee offer a competitively priced insurance product rather than selling our own plan,” Retirement Income Security Act said Criste. He added that Canopy Health currently contracts only with Health Net (ERISA) and does not qualify as an but is in discussions to form partnerships with other insurers to join its network. ERISA "church plan.” According to a Canopy Health will launch this fall with approximately 13,000 University July 29 report from Courthouse News of California employees. Canopy signed a contract with Health Net to provide Service, the Ninth Circuit court ruling coverage for employees and families covered under its Health Net Blue & Gold upholds a U.S. District Court, Northern Plan with San Francisco Hill Physicians Medical Group. It will also offer its California ruling that Dignity Health's HMO plan to more UC employees this fall during open enrollment for coverage retirement plan does not qualify for starting in January 2017. the ERISA exemption because it John Muir and UCSF join a growing list of health systems forming their own was not established by a church. In health plans. In 2015, Sutter Health launched an HMO called Sutter Health a 26-page opinion, U.S. Circuit Court Judge William Fletcher wrote that Plus in the Sacramento area and now operates in more than a dozen counties in "the parties' dispute would have been Northern California. The HMO includes a network of 25 hospitals and more than easily resolved under ERISA's original- 5,600 physicians and now has more than 37,000 members. ly enacted text, which unambiguously A 2016 report from McKinsey & Company found that “offering a health provided that a church plan must have plan can give health systems an opportunity for growth but is not without finan- been established by a church." Dignity cial risk,” noting that “40 of the 89 provider-led health plans we analyzed have Health formed its retirement plan as a had negative margins in some or all of the past three years.” The report also church plan in 1989 under its former noted that, “health systems, if they are to benefit from offering a health plan, will name of Catholic Healthcare West. In need to be able to understand how they can use consumerism to their advantage 2013, a former Dignity employee sued and where the best opportunities for growth exist.”—DOUG DESJARDINS the health system and challenged its right to operate a church plan, which provides benefits not extended to reg- ular retirement plans and are not sub- Huntington Hospital to Take Part ject to disclosure, funding, and vesting requirements that regulate private in End of Life Option Act sector plans. California hospitals not expected to play large role in new law ° The University of California Board Huntington Hospital in Pasadena announced that it will participate in the End of Regents agreed to pay nearly $8.5 of Life Option Act but that it doesn’t expect to be part of many end-of-life plans. million to settle two lawsuits that allege The hospital made its announcement in a Letter to the Community pub- a UCLA spine surgeon failed to dis- lished in the July 31 edition of the Los Angeles Times. close conflicts of interest with medical "Earlier this year, our hospital began ongoing, thoughtful deliberations about device manufacturer Medtronic while whether and how to participate in this new law," the Letter to the Community using the company's products to per- stated. "In June, as the law came into effect, we announced that we would partici- form surgeries. According to a July 29 pate in the act while we completed our deliberations. Now, after careful evaluation « CONTINUED ON PAGE 3 » « CONTINUED ON PAGE 3 » HIRE POWER: HEALTHFAX CLASSIFIED ADS WORK! PAGE 3 CALL 978-624-4594 For subscription services, call 800-753-0131 August 8, 2016 TOP STORIES CONTINUED FROM PAGE 2 IN BRIEFContinued from page 2 Huntington Hospital cont. report from the Los Angeles Times, the $4.25 million and $4.2 million settle- of the law … our board of directors determined that Huntington Hospital will con- ments resolved cases involving Jeffrey tinue to participate in the End of Life Option Act. As has always been the case, Wang, MD, UCLA, and Medtronic, physicians will individually decide whether to participate or not." and two former patients who claimed Huntington Hospital officials began debating the merits of opting out of the their surgeries led to recurring pain new law in April and considered the opinions of hundreds of physicians, nurses, and the need for additional surgeries. The lawsuits claimed that from 2004 clinicians, and administrators. "In conversations with our physicians, palliative to 2013, Medtronic paid Wang more care experts, nurses, bioethicists, patients, and the community, the most critical than $275,000 for consulting work, factor in end-of-life discussions is individual choice," the letter stated. lectures, and product royalties while The Letter to the Community added that, "we fully respect those who dis- Wang was using Medtronic products agree with the law and expect it will be quite rare that patients choose to end in surgeries. UCLA said it agreed to the settlement "so that UCLA Health their own lives in our hospital." Huntington Hospital cited data from Oregon— and the David Geffen School of the first state to approve a death with dignity law—that shows physician aid- Medicine at UCLA could move for- in-dying at hospitals is rare. ward with their ongoing commitment "In Oregon, for example, which has had a similar statute in place since 1998, to excellence in patient care, research, patients have overwhelmingly decided to exercise this option outside of a hospital education, and community service." Medtronic also denied any wrongdoing setting. According to the most recent Oregon data, 990 of the 991 patients who and said that Wang "was not paid for terminated their lives chose to do so in their homes or in non-hospital settings." using the Medtronic products used in Jan Emerson-Shea, vice president of external affairs for the California the surgery." Hospital Association (CHA), said the CHA encourages all hospitals to adopt a policy regarding the End of Life Option Act but does not expect hospitals to play ° Nine hospitals in California received five-star ratings from the Centers a large role in implementing the law.

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