A solution to the health-care problems facing West County in the wake of the continuing financial difficulties at Doctors Medical Center is likely attainable but will include a reduction in hospital services, according to leaders of a Stakeholder Group charged with identifying viable alternatives.
In its first public statement since announcing the formation of the group last month, members said they have identified several promising interim strategies to retain essential emergency services and reduce expenses while a long-term solution is evaluated.
The Stakeholder Group was announced in June by members of the Hospital Council of Northern and Central California and Contra Costa Health Services. It is comprised of representatives from the county, physicians, clinics, the West Contra Costa Healthcare District, the state Health and Human Services Agency and top executives of Kaiser Permanente, John Muir Health, Lifelong Medical Care and Sutter Health. It also includes experts in health-care finance, medical law and reimbursement who are funded by the member hospitals of the Hospital Council.
The technical experts in the group are developing financial and operational models for a variety of scenarios, taking into account state licensing requirements and the complexities of the health-care marketplace. Among the goals would be to reduce administrative and infrastructure expenses and develop strategies for more adequate Medicare and Medi-Cal reimbursement rates.
This technical advisory group (TAG) will then present alternatives for short- and long-term solutions to the full group for consideration.
The full stakeholder group will make its recommendation to the West Contra Costa Healthcare District Board, with the goal of having an interim care alternative in place by Sept. 1. The resulting expense reductions will keep essential services operating while a long-term, self-sustaining solution is evaluated and selected.
The group was formed at the request of the Healthcare District to evaluate an alternative to a full-service Doctors Medical Center, which despite extensive efforts to reduce costs faces losses of $18 million annually – a deficit that is expected to grow with planned cuts to Medicare.
Among the short-term solutions being evaluated by the Stakeholder Group are financial and legal health-care experts is a scaled-down hospital that retains the same number of emergency beds and 15 beds for acute medical, surgical and intensive care patients.
“We remain optimistic that a viable alternative can be found that meets the most important health needs of West County as identified in a study by county Health Services — emergency care,” said Dr. William Walker, Contra Costa Health Officer and the leader of the Stakeholder Group.
“We are modeling out the various alternatives to determine which services are affordable and the most essential,” Walker said. “Our goal is to ensure that the services retained provide the maximum amount of care in a way that is self-sustaining.”
“I want to be clear that under all the scenarios we have identified as appropriate for study, Doctors Medical Center is reduced in size and scope of operations,” Walker said. “It is unrealistic to continue to push for the retention of a full-service hospital given that losses continue to mount, despite a 20-year effort to save Doctors Medical Center.”
“The county is not in a position to adequately fund or take over Doctors Medical Center, particularly given the changing and uncertain nature of the health-care marketplace,” said Walker.
As part of its evaluation of short-term options, the stakeholder group is also considering a satellite emergency department at the current location.
While no decisions have been made, the focus is on maintaining emergency services for the thousands of patients who have come to rely on Doctors Medical Center each year. Urgent care is also considered essential and is expected to be part of a continuum of health services put in place.
A clinical plan is also being developed to coordinate emergency services and transportation issues with the region’s hospitals. Dr. Joseph Barger, Medical Director for Contra Costa’s Emergency Medical Services Agency, is leading the effort, working closely with the region’s emergency department medical directors. Barger and the emergency room physicians believe that a satellite emergency department is clinically viable.
Transfer agreements will be bolstered in order to ensure the swift and secure transfer of patients from the scaled-down hospital or satellite emergency department to nearby full-service hospitals as necessary. Emergency care will also be supplemented by an increase in same-day appointments at West County health clinics.