1 March 2012

California Edition
Calendar
March 8-10
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CalOptima Chairman Put In Limbo

Supervisors Want FPPC or Grand Jury Investigation
The Orange County Board of Supervisors voted Tuesday to delay a normally routine reappointment of the chairman of the CalOptima board of directors and voted against another directors reappointment over potential conicts of interest. The 3-2 vote to delay the reappointment of Edward B. Kacic came after Payers & Providers reported last week he co-chaired one organization vying for $12.7 million in intergovernmental transfers from CalOptima and a philanthropic organization he heads had applied for another $9.3 million federal grant. In both instances the funds would be used to provide care for CalOptima enrollees via medical homes and other new programs. CalOptima, which is Orange Countys Medi-Cal managed care plan, has about 400,000 enrollees and $1.4 billion in annual revenue. Kacic has insisted that the grant money would not have nancially beneted the Irvine Health Foundation, where he serves as its president. I am uncomfortable supporting all of these reappointmentsthere could be a potential (Fair Political Practices Commission) issue regarding his role on the CalOptima board and as a founder of the Managed System of Care, said Supervisor Janet Nguyen, who is also a CalOptima director. The Managed System of Care is a potential recipient of the $12.7 million from CalOptima. Although Nguyen praised the Irvine Health Foundations work in the community, she added that Kacics current relationships at a minimum create the potential of the appearance of a conict. The Supervisors agreed that no vote on Kacics reappointment would take place until any investigations regarding his relationships with CalOptima, the Managed System of Care and the Irvine Health Foundation are complete, whether by the FPPC or a grand jury. Kacics term is set to expire on Sept. 30. Such investigations can be requested by individuals or a legislative body, although the Supervisors did not vote to take any specic action. I think the best thing to happen here is to have some third party (look into this), said Supervisor Patricia Bates. She noted that being subject to such allegations had an effect on her career and family life. An FPPC investigation of Bates in 1990 concluded she broke state law but did no harm when she chaired meetings of the Laguna Niguel City Council while debating a ridgeline protection ordinance that would have impacted land she owned. Supervisor Bill Campbell downplayed any notion of conicts of interest or self-dealing involving Kacic, but still wanted the matter

March 13
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February 29
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NEWS
CalOptima (Continued from Page One)
investigated. (Kacic) may be involved in the three entities and there may be some technical reason he cant participate in all three, observed Campbell, who is an alternate CalOptima board member. Campbell also noted that Kacic had disclosed a number of investments related to healthcare entities on annual forms he is required to submit to the FPPC, although he did not elaborate. This is just a good question to ask. Neither he nor we want to wind up in a situation where were embarrassed, Campbell added. Kacic said in a statement Wednesday there was no merit to the claims and he would continue in his role at CalOptima. In addition to moving to table Kacics appointment, the board declined to renew

Page 2

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In Brief
DMHC Orders Kaiser To Cover Physical And Related Therapies
The Department of Managed Health Care has ordered Kaiser Foundation Health Plan to cease and desist from denying enrollees access to physical, occupational and speech therapy. According to the DMHC, it has received more than 100 complaints from Kaiser enrollees who had been denied such services. Kaiser had claimed the enrollees did not have a physical condition linked to surgery, trauma or a congenital condition. However, California law regarding health maintenance organizations considers such services to be medically necessary. Kaiser Health Plans policy to deny physical, occupational, and speech therapy services for nonphysical conditions is not permitted under the Knox-Keene Act, said Anthony Manzanetti, DMHCs chief of enforcement.

director Adriana Morenos appointment, also set to expire on Sept. 30. Nguyen noted that Moreno is employed by the Childrens Health Initiative of Orange County, which receives ofce space and other assistance from CalOptima valued at around $80,000 a year. This was not disclosed during the nomination process a year ago, Nguyen said. Had it been brought to my attention, I would not be able to support it today. Nguyen, who represents a district in Northern Orange County, has been exing her political muscles over CalOptimas governance. She successfully supported a 2011 ordinance that expanded the board from and extended her term by a year. Three other sitting CalOptima directors James McAleer, Lee Penrose and Mary Anne Foo were reappointed Tuesday.

Blue Shield Enters Into Another ACO

Arrangement in O.C. Focuses on Diabetes Care
Blue Shield of California has entered into another accountable care organization arrangement, teaming up with major Orange County providers to try and cut premium costs. The ACO, between the San Franciscobased health insurer, Hoag Memorial Hospital Presbyterian and Greater Newport Physicians, both in Newport Beach, will focus on cost controls for 11,000 enrollees in Blue Shields health maintenance organization. It will launch on July 1 and operate for at least three years. It's another milestone in our ongoing effort to transform how we provide and pay for care to make health coverage more affordable to all Californians," said Juan Davila, senior vice president of network management for Blue Shield of California, in a joint statement issued Tuesday. Davila was not made available for comment, and a Blue Shield spokesperson did not respond to written questions submitted for comment. The three entities vowed to use the ACO model which includes bundled payments to Hoag and Greater Newport for specic episodes of care to keep premiums for the group stable for the next year and keep future annual increases in the low double-digits. If the goals are achieved, it would be a signicant break from Blue Shields current pricing trend it recently led a request with the California Department of Insurance to raise premiums on individual preferred provider organization enrollees by an average of nearly 8%, with some policies rising nearly 15%. Amanda Weig, spokesperson for Greater Newport Physicians, said the new ACOs enrollees would come from the medical groups general population of capitated patients. However, specic attention would be paid to enrollees suffering from diabetes. Those enrollees will have their conditions monitored and treated through a new clinic the medical group is operating in conjunction with Hoag and funded by a Blue Shield grant. The new ACO is Blue Shields sixth in California. Its most prominent effort, in conjunction with Hill Physicians Medical Group and Dignity Health (formerly Catholic Healthcare West) in Northern California involves more than 38,000 enrollees in the California Public Employees Retirement System. The effort sharply reduced hospital readmissions and was saving about $14 million a year. In the statement, Blue Shield said it would seek approval from the Department of Managed Health Care for the new ACO, suggesting it would take the form of a riskbearing organization.

L.A. Care Enrollment Tops 1 Million

L.A. Care Health Plan, the Medi-Cal managed care plan for Los Angeles County, announced on Wednesday that its enrollment broke the 1 million mark. The Los Angeles-based plan has been growing dramatically in recent years due to expansions of the MediCal program caused by the Great Recession and the shifting of certain disabled and low-income Medicare beneciaries into managed care coverage. L.A. Cares enrollment includes 963,000 Medi-Cal enrollees, 17,000 enrollees in Healthy Families, 40,000

Continued on Page 3

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Prem Reddy Steps In As Prime CEO

Interim Role After Lex Reddys Sudden Departure
The chairman of the board of troubled hospital operator Prime Healthcare Services has taken over the duties of chief executive ofcer after its longtime CEO resigned abruptly last week. Prem Reddy, M.D., a cardiac surgeon by training who founded the Ontario-based Prime , is replacing his brother-in-law Lex Reddy after he announced last week he was stepping down. Lex Reddy has been an important part of our success, and he will be missed, Prem Reddy said in a statement. He will serve as an interim CEO until a permanent replacement is found. In another move, Luis Leon, a longtime Prime employee who most recently has overseen operations of Primes hospitals in the San Diego region, has been appointed chief operating ofcer. Prime, which operates 14 hospitals statewide, has come under increased scrutiny after the non-prot investigative journalism organization California Watch published a series of articles about its billing practices for patients diagnosed with septicemia and a rare form of malnutrition. Prime also drew re for disclosing the medical records of a patient who had claimed to have been billed for treatments she never received. Although Prime recently backed out of a deal to acquire Christ Hospital in Jersey City, N.J., it announced the acquisition of 137-bed Roxborough Memorial Hospital in Philadelphia last week from Solis Healthcare LLC. Terms of the transaction were not disclosed. The deal is the rst where Prime has acquired a hospital outright outside of California. Solis had purchased Roxborough from Tenet Healthcare Corp. in 2007 for $25.5 million.

In Brief
in-home support workers who qualify for state-sponsored coverage and 2,600 Medicare Advantage enrollees. It covers roughly one in ten residents of Los Angeles County. That we are growing so dramatically speaks to our stellar reputation and strong working relationships with all our stakeholders, from our members to our partners, physicians, and the communities we serve, said L.A. Care Chief Executive Ofcer Howard Kahn. In addition to the enrollment growth, L.A. Care ofcials said it has contributed nearly $132 million to strengthen the countys safety net.

Greater Newport, MemorialCare Enter Into Affiliation

Greater Newport Physicians medical group has afliated with Long Beachbased hospital operator MemorialCare Health System. MemorialCare also acquired Greater Newports management services organization, Nautilus Healthcare Management Group. Greater Newport has 400 afliated physicians, with 140 practicing primary care and the remainder practicing as specialists. Specic terms of the afliation were not immediately disclosed. Greater Newport will operate as the independent practice association division of MemorialCare. Nautilus has about 400 employees. We are proud to expand our family of providers to deliver even more of the high quality, comprehensive care MemorialCare is known for, said Barry Arbuckle, MemorialCares chief executive ofcer. The strength of this new, deeper partnership between Greater Newport Physicians and MemorialCare is rooted in our shared values and passionate commitment to superior quality and exceptional service.

Kaiser Finds Pediatric Asthma Link

Heavier Children More Likely to Contract Disease
A study of Kaiser Permanentes pediatric enrollees in Southern California found a connection between overweight and obese children and rates of asthma. Overall, children who are overweight or obese are about 18% more likely to contract asthma, according to the study, which examined the electronic health records of 681,000 children between the ages of 6 and 19. However, the study found that the connection between body mass and asthma tended to be weaker among African-American children and stronger among Latino kids. "This research contributes to the growing evidence that there is a relationship between childhood obesity and asthma, and suggests that factors related to race and ethnicitymay modify this relationship," said Mary Helen Black, a Kaiser researcher and lead author of the study. Earlier this month, Kaiser earmarked a $5 million grant to the Institutes of Medicine to help combat nationwide obesity rates. The asthma study was published in the most recent edition of the medical journal Obesity.

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Payers & Providers

OPINION

Page 4

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Patient Safety Through The Union Prism

Hospitals Need to Get Upper Hand on a Sensitive Issue
reports before any research is made as to the Much has been written about the patient legitimacy of the claims. safety issues confronting healthcare and the Just the threat of a well-funded public challenges healthcare providers face, not only attack can be sufcient for hospitals to alter for enhancing patient health, but doing so at their positions and make decisions which are the safest levels possible. not in the best interest of the future of the Healthcare providers have always faced a hospital or the community at large.. key dilemma - how much of the organizations The nurses unions are particularly adept resources should be focused on improving at painting a picture that the registered nurse safety, instead of promoting to the community is the only person in the hospital truly its high level of safe care? Conventional concerned about the safety of the patients. wisdom would say that if hospitals actually Their message conveys that physicians and provide a safe care environment, that would hospital executives have all sold out to be clear to the community and there would be nancial gain at the expense of the patient. an overall belief that the hospital is safe. What can hospitals do to diminish the Hospital marketing budgets have impact and effectiveness of these patient safety increased during the last few years as the attacks? Simply put, hospital leadership needs competition for patients has increased. There to take back the patient safety mantle from the have been a number of very effective ad union and promote to the public that the top campaigns to increase the reputation of priority of the hospital is to provide safe care. hospitals and to try to gain or maintain their If the community at large trusts that hospital patient base. Few marketing efforts, though, leadership and physicians are foremost focus on patient safety. concerned about patient safety, then the The California Nurses Association By union attacks can simply be diminished and the newly minted National Nurses Kevin by exposing them as negotiating tactics United (a handful of state nursing associations with the CNA in the lead), Haeberle that do not truly reect the state of care at the hospital. believe that the majority of communities A well funded, long-term, and carefully have negative perceptions of patient safety. Its orchestrated campaign to mold the leaders have been determined to use public community perception of patient safety should disclosure of isolated unsafe care be a top priority. Having caregivers, environments as a way to tarnish hospital physicians, and nurses speak of the reputations and to gain them bargaining commitment by hospital leadership for patient leverage, or to force hospitals to allow unions safety should be at the core of any public to more easily organize nurses. campaign. Being open to managing the These unions have money, are motivated, communitys perception of care issues in and are willing to embellish the facts to create healthcare limits the unions effectiveness in a horric picture for the community overall, as showing isolated incidents as being the norm well as for future hospital patients, physicians, for the hospital. and employees. A patient advocacy program should be Unions are maximizing the use of social publicly promoted and reinforce that patients media and turning nurses into union agents have someone to go to with concerns. that look for everyday issues and create The time to act is now because the patient clandestine video footage of a leaking pipe in safety attacks are sure to increase over the a patient room, a patient in a soiled bed, an coming years as the CNA spreads its tactics infected surgical site, or off-handed remarks across the nation by bringing more and more by hospital executives. state nursing associations under the umbrella Moreover, news outlets have become of the National Nurses United. much more competitive and they fear that a video may go viral without the local newspaper, radio, or television station being Kevin Haeberle is the senior vice president for aware. This fear of becoming irrelevant has Integrated Healthcare Strategies. resulted in the willingness of these traditional media outlets to publish or air unsubstantiated

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Payers & Providers

MARKETPLACE/EMPLOYMENT

Page 5

MARKET EXPANSION PROFESSIONAL

JOB SUMMARY: Plan, design, and complete processes to achieve business objectives for network and membership growth via market expansion. Manage and perform a broad range of tasks using resources effectively and efficiently to meet identified timeframes for planned product and service expansions. This includes coordination of efforts and collaboration with external entities to meet all regulatory requirements and to ensure market expansion filings are fully compliant and approved. ESSENTIAL JOB RESULTS: Coordinate and execute complex tasks related to network and membership growth via market expansion, in order to ensure the successful completion of ongoing cycles of work. Utilize detailed work lists to manage the timely completion of tasks for each phase of a particular market expansion process and provide necessary updates to management, escalating risks as appropriate. Develop and maintain positive relationships with internal departments and external entities, creating partnerships to achieve program objectives. Effectively communicate and assign deliverables and timelines. Monitor and manage the assigned tasks to achieve timely completion. Monitor quality of tasks performed, develop and recommend process improvements for implementation. Assure a quality market expansion process outcome by making sure that each finished task meets the required level of quality. As needed, troubleshoot issues and provide innovative solutions, focused on continuous quality improvement. Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Contribute to team effort by accomplishing related results as needed. QUALIFICATIONS: Bachelors Degree required. Preferred area of study: Business or Health Administration, Management or Process Engineering. Experience within Healthcare/ Managed Care, preferred. Demonstrated interpersonal skills with the ability to compromise, persuade, and negotiate, be well-rounded and have excellent communications skills. Solid leadership skills, excellent written and verbal communications skills and ability to establish effective working relationships with many different people, ranging from managers, supervisors, and professionals, to administrative and support staff personnel. Analytical, detail-oriented, flexible, and decisive. Ability to coordinate several activities at once, quickly analyze and resolve specific problems, and manage deadlines. Ability to work with minimal supervision, so need to be self-motivated and disciplined. Expert skills in MS Office productivity software and strong computer skills are essential. FT position, M-F 8 AM to 5 PM, with extended work hours and possible travel, as needed. Must maintain valid drivers license, automobile insurance and reliable transportation. Apply to www.scanhealthplan.com - Job Opportunities Req. #12-612

SENIOR HEALTHCARE ANALYST

JOB SUMMARY: This position will support the HCC and Encounter Team in Health Care Informatics by collecting and analyzing healthcare related data by performing data management, quality improvement studies and by conducting statistical analysis and generating reports for the organizations decision makers. ESSENTIAL JOB RESULTS: Support operational needs by performing complex analyses on a wide range of organizational data - investigate and uncover root causes, identify trends, etc. and propose solutions. Achieve results by effectively leveraging expertise in healthcare/managed care data including, but not limited to, membership, provider, claims, authorizations, pharmacy, and financial information. Commitment to customer service achieved through timely, accurate, and supportable deliverables. Support customer needs for what-if scenario analysis by developing analytical tools/models. Ensures understanding of customer needs by proactively clarifying scope and requirements and keeps customers apprised of project status through effective communication. Achieves high-quality deliverables by assuring accuracy and thoroughness in executing projects. Manages multiple (department) projects by effectively prioritizing work and communicating workload issues to management. Develops and maintains up-to-date knowledge of the Data Warehouse and other organizational data sources. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Contributes to team effort by accomplishing related results as needed. QUALIFICATIONS: Bachelors Degree, or equivalent experience required. 4+ years of proven analysis experience highly preferred, or 2+ years of proven analysis experience in a Healthcare/ Managed Care environment highly preferred. Ability to effectively interact with, and present findings to customers at all levels of the organization including operational managers, medical directors and executives required. Proficiency with MS SQL (queries) highly preferred. Clinical code knowledge related to claims/utilization highly preferred. Experience with managed care contract terms/analysis a plus. Experience in a Medicare Advantage environment a plus. Experience with MS BI products a plus. Expert skills in MS Office productivity software, especially MS Excel. Excellent technical, interpersonal, written and oral communication skills required. Superior analytical skills required. FT position, M-F 8 AM to 5 PM, with extended work hours and possible travel, as needed. Apply to www.scanhealthplan.com Job Opportunities Req. #11-540

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MARKETPLACE/EMPLOYMENT

Page 6

It costs up to $27,000 to fill a healthcare job*

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Employment listings begin at just $1.65 a word Call (877) 248-2360, ext. 2 Or e-mail: advertise@payersandproviders.com Or visit: www.payersandproviders.com
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Alameda Alliance for Health is a public, not-for-profit managed care health plan for lower income people in Alameda County. The Alliance provides healthcare coverage to over 130,000 children and adults through four programs: Medi-Cal, Healthy Families, Alliance Group Care, and Alliance CompleteCare.
This position assists in the day-to-day supervision of Claims staff and claims work flow ensuring that all claims are adjudicated within appropriate time frames. This position will train Claims staff and advise management on opportunities to improve claims processing procedures. Medicare claims processing experience is required. Must have detailed knowledge of claims coding and forms and the ability to correctly interpret and communicate claims processing rules, regulations, and procedures to staff and external customers. 3 years of experience in a medical managed care claims processing environment and 1 year of supervisory experience is required. A High School Diploma and relevant experience is required with a B.S. degree preferred. Excellent salary & benefits.

SUPERVISOR, CLAIMS RESOLUTION

This position will oversee the application portfolio and be responsible for the overall functionality and configuration of systems that support the organization. The position will also manage the performance and functions of analysts who are responsible for configuration including planning, reviewing and controlling activities of project team members. Will also identify solutions that result in high quality, cost effective support to all levels of users including support for both the technology and business processes. Must have a minimum of 7 years managerial and professional experience in the applications or information systems field and technical work experience in positions such as configuration/ development analyst, business analyst, systems analyst, etc., in a managed care organization. Excellent salary & benefits.

DIRECTOR, APPLICATIONS & CONFIGURATION

Please visit our website at www.alamedaalliance.org and click on the Careers button for more specific job information and to apply for these positions. EEO.

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MARKETPLACE/EMPLOYMENT

Page 7

MDS Consulting is a national healthcare consulting firm with substantial healthcare management experience working in and with hospitals, medical groups, health systems, and other healthcare organizations. Qualified candidates should email their rsums and expectations to blambon@mdsconsulting.com VICE PRESIDENT OF PHYSICIAN SERVICES MDS Consulting is seeking a consulting leader that is highly experienced in medical group, medical foundation, and physician practice development and operations. The successful candidate will have depth of knowledge regarding compensation plans, information technology, organizational structure and finance related to medical groups, IPAs, and ACOs. Development skills in client relations, team management, communications, and report writing a necessity. Position located in Southern California and requires a Masters degree in related field and at least 10 years of related experience. SENIOR MANAGER OF PHYSICIAN SERVICES The Senior Manager of Physician Services manages client engagements related to medical group operations, physician/hospital alignment models, physician contracts, compensation and fair market value studies, etc. Candidate will have excellent analytic and communication skills and a strong financial background. Masters degree with at least 5 years of related experience required. The position is based in Los Angeles.

DIRECTOR OF PROVIDER NETWORK DEVELOPMENT & SERVICES (Managed Care)

The Health Plan of San Mateo (HPSM), an innovative Medicaid and Medicare health plan, seeks a strategic thinker and doer to guide development of its network strategies as it embarks on significant new program ventures and prepares for health reform. Reporting to the Chief Executive Officer and as a senior manager of the organization, the Director will maintain responsibility for the strategic development and management of HPSMs provider network, including contracting, compliance, quality, provider relations, and associated activities and data analysis; and provide direction to department staff. Requires a Bachelors degree in Business Administration, Healthcare Administration or a related field; a Masters degree is preferred. 5 years contracting and network development/management experience in a managed care setting (HMO, IPA/Medical Group or equivalent) at a senior management level. Please visit www.hpsm.org for more information about the position and the excellent benefits offered. For immediate consideration, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 701 Gateway Blvd., Suite 400, South San Francisco, CA 94080. Email: careers@hpsm.org. Fax: (650) 616-8039. Phone: (650) 616-0050. EOE

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