North Bay Business Journal

SACRAMENTO — Covered California, the state’s online health exchange established under the Affordable Care Act, today announced that 13 commercial health plans will take part in its individual marketplace, while introducing premiums that vary from region to region.

A Sonoma County-based nonprofit and several others with ties in the North Bay are among 48 organizations across the state to share in $37 million in outreach and education grants from Covered California, the state’s online health exchange developed under health care reform.

Petaluma-based Redwood Community Health Coalition received $830,000. Catholic Charities of California, which has a presence in Solano, Napa, Sonoma, Lake and Mendocino counties, received $859,000. California Rural Indian Health Board, which has a presence in Sonoma and Mendocino counties, was given $300,000. The California NAACP, which has locations in Sonoma and Solono counties, received $600,000 and the Asian Pacific American Legal Center in Solano County received $100,00.

Health insurance brokers, employers and individuals are all eagerly awaiting full-scale implementation of the California Health Benefits Exchange, a centerpiece of the Affordable Care Act, but it’s still anyone’s guess as to what it will look like.

Share your thoughts on this week’s NBBJ Pulse poll question: “Will the Affordable Care Act be ready to implement in California in January 2014?”

Health insurance brokers, employers and individuals are all eagerly awaiting full-scale implementation of the California Health Benefits Exchange, a centerpiece of the Affordable Care Act, but it’s still anyone’s guess as to what it will look.

While details of what the exchange, also known as Covered California, will look like have emerged recently, a key piece of just how effective it will has not yet been determined: the monthly premiums for plans that will be offered to individuals and employers.

FAIRFIELD — Partnership HealthPlan of California, a nonprofit that administers Medi-Cal benefits in six counties, said recently that it is looking to fill 100 positions over the next 12 months after expanding significantly further into Northern California.

SAN RAFAEL — Burnham Benefits Insurance Services, a sizable employee benefits brokerage based in Irvine, announced it would open a new branch in San Rafael, where it hopes to capitalize on proximity to San Francisco in driving growth in Northern California.

Employers will increasingly resort to self-funded plans for group health insurance as a result of the Affordable Care Act, according to a new survey of insurance executives by one of the world’s largest re-insurers.

A common financial planning “hot button” is worry over the cost of healthcare on a fixed income in retirement. While we cannot predict how much care a retiree will need or his/her actual life expectancy, health care risks can be mitigated by maintaining good health, understanding Medicare and by informed financial planning.

Employers large and small are bracing for the full implementation of health care reform, but smaller businesses with at least 50 employees are especially anxious when it comes to a key question: do they provide benefits for full-time workers or pay a fine for each full-time worker not covered?
The employment sector could stand to benefit, particularly staffing agencies already adept at providing leaner workforces for employers in a number of industries, employment experts said.

Health plans and providers in the North Bay overall received high marks in a state survey from the state Office of the Patient Advocate.

The Sonoma County Board of Supervisors appointed Susan Klassen transportation and public works director. …

Sonoma County Supervisor Shirlee Zane was elected to the board of directors for the National Committee to Preserve Social Security and Medicare Foundation. …

Fireman’s Fund Insurance Co. named Jay Dipasupil vice president of programs and Dan Reed vice president of professional liability. …

SONOMA — California Insurance Commissioner Dave Jones, in Sonoma for a speaking engagement, continued to apply public pressure on Blue Shield of California and other large insurers for recent rate hikes, saying the increases will negatively impact individuals and small businesses disproportionally and that the increases aren’t in tune with national medical inflation rates.

Nearly every major health care provider in the region has recently opened a new clinic or outpatient center, and numerous others have said plans are under way for similar expansions, reflecting a concerted effort by providers to move outside of the hospital setting. …

Marin General Hospital recently opened the Baden Diabetes Center, an outpatient program that provides self-management skills, treatment and on-going guidance for patients with diabetes. …

NorthBay Healthcare is in the process of developing a new medical office building in Fairfield adjacent to its administrative center at 4500 Business Center Dr. …

St. Joseph Health recently completed the move if its Memorial Hospice program to 439 College Ave. in Santa Rosa, where it will occupy 12,000 square feet. …

Northern California Center for Well-Being will hold its third annual Workforce Wellness Symposium this month at Santa Rosa Memorial Hospital. …

Spotlight on law firm managing partners, listed alphabetically by law firm name: Patrick Emery of Abbey, Weitzenberg, Warren & Emery, Wendy Whitson of Anderson, Zeigler, Disharoon, Gallagher & Gray, Michael Garcia of Beyers Costin, Arthur Curley of Bradley, Curley, Asiano, Barrabee & Gale, Alan Brayton of Brayton Purcell, John Mackie of Carle, Mackie, Power & Ross, Clay Clement of Clement, Fitzpatrick & Kenworthy, Cynthia Smith of Coombs & Dunlap, Scott Gerien of Dickenson, Peatman & Fogarty, Katherine Ohlandt of Farella Braun + Martel, Peter Kleinbrodt of Freitas, McCarthy, McMahon & Keating, John Friedemann of Friedemann Goldberg, Dave Gaw of Gaw Van Male, Michael Carlson of Geary, Shea, O’Donnell, Grattan & Mitchell, Andrew Giacomini of Hanson Bridgett, Jessica Karner of Keegin Harrison Schoppert Smith & Karner, Bill Arnone of Merrill, Arnone & Jones, Anne Hernandez of Mullen & Filippi, James Parrinello of Nielsen, Merksamer, Parrinello, Mueller & Naylor, Michael Watters of O’Brien Watters & Davis, James Sell of Parton Sell Rhoades, Leslie Perry of Perry, Johnson, Anderson, Miller & Moskowitz, David Feingold of Ragghianti Freitas, Glenn Smith of Smith Dollar, Gregory Spaulding of Spaulding McCullough & Tansil, and Michael Vasquez of Vasquez, Estrada & Conway.

Kaiser Permanente has earned accreditation for its Santa Rosa Medical Center Family Residency Program, which was developed to attract and retain more physicians to the region in lieu of national shortages.

Throughout the debate and the recent implementation of health care reform, health experts and politicians alike have touted the shift away from the fee-for-service model to more coordinated care, leading to better outcomes and lowered spending.

Beginning this year, however, the financial health of hospitals will likely depend on just how well care is coordinated, as a relatively little-known yet critically important piece of the Affordable Care Act is enacted: the “Hospital Value-based Purchasing Program,” overseen by the Centers for Medicare and Medicaid.

Value-Based Purchasing is a Medicare program started in January that seeks to hold hospitals accountable for the care they provide.

Last year, Medicare rolled out penalties for hospitals that have too many returning patients within a month.

This chart shows the effect of the two programs combined.

SANTA ROSA — Santa Rosa Memorial Hospital and Advanced Surgery Institute, LLC, entered a joint venture on operations of a central Santa Rosa ambulatory surgery center, where 19 local surgeons from a wide range of medical specialties have performed outpatient procedures since its opening in 2010, it was announced today.

SANTA ROSA — Santa Rosa Memorial Hospital and Advanced Surgery Institute, LLC, have entered into a joint venture on operations of a central Santa Rosa ambulatory surgery center, giving Memorial further reach beyond hospital walls as health care providers seek to expand outpatient services.

NOVATO — Novato Community Hospital today announced it is one of seven California providers to partner with the Centers for Medicare and Medicaid on bundled payments, an initiative under the Affordable Care Act that seeks to lower health care costs while improving quality.