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2 Sides Negotiate for Health-Care Pact

July 08, 1998|HILARY E. MacGREGOR

Blue Cross and the Catholic HealthCare West hospital chain were negotiating down to the wire Tuesday in a last-ditch effort to hammer out a new contract.

But if terms could not be reached--which appeared likely Tuesday evening--both organizations have agreed on a transition plan.

Catholic HealthCare West runs St. John's Pleasant Valley Hospital in Camarillo and St. John's Regional Medical Center in Oxnard.

As of midnight Tuesday, Blue Cross patients who use a hospital owned by Catholic HealthCare West would be directed by doctors to an alternative facility that accepts Blue Cross.

Blue Cross is accepted at seven other health care facilities in Ventura County, including Columbia Las Robles, Community Memorial Hospital, Ojai Valley Community Hospital, Santa Paula Community Hospital, Simi Valley Hospital and Ventura County Medical Center.

If patients choose to use the Catholic HealthCare West hospital anyway, they will have to pay the same prices as they would if they went to a hospital that did not participate in the Blue Cross health plan.

Those affected by the plan are Blue Cross members who have the Prudent Buyer, California Care, Senior Care and point-of-service health plans.

Exceptions will be made for those who are already undergoing a course of treatment for cancer, health services rendered at home or speech or occupational therapy treatments. Those patients will be allowed to continue their treatments through the end of the year.

In addition, maternity patients who have due dates on or before midnight Dec. 31 will be able to use Catholic HealthCare West facilities.

Rhonda Seaton, a spokeswoman for Blue Cross, said Blue Cross and Catholic HealthCare West were unable to negotiate a new contract because Catholic HealthCare West wanted more reimbursement.

Blue Cross has already renegotiated contracts with five out of six of the largest hospital systems in the state: Tenet, Sutter Health, Adventist Health, UniHealth and Columbia HCA.

Catholic HealthCare West is the only holdout, Seaton said.

"What happened with Catholic HealthCare West is they wanted higher reimbursement," Seaton said. "They want more than any of the other five. And that will drive up the cost of health care for everyone."

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