'Informational' talks with HMO could lead to 'good fit' for plan members

SONOMA COUNTY -- Members of a regional effort to create a strong network of physicians across the North Bay are in early talks with a Sacramento-based health maintenance organization about forming an insurance product around the nearly 500-member physician network, with the possible goal of offering a commercial health plan to employers.

The Northern California Healthcare Authority was set to hold a Regional Access Plan meeting Thursday with members of the Marin-Sonoma Independent Practice Association and Annadel Medical Group to hear preliminary information from Western Health Advantage’s chief executive officer Garry Maisel.

Daymon Doss

Daymon Doss, chairman of the health care authority and former chief executive officer of Petaluma Healthcare District, stressed that talks are very much preliminary and informational. But he said the not-for-profit insurer could potentially be a good fit for the health care authority and members of the Marin-Sonoma IPA.

“What’s really interesting is that they are a commercial HMO and their structure is very similar to the now-defunct Health Plan of the Redwoods, though they’ve been able to thrive,” Mr. Doss said.

Health Plan of the Redwoods was a Santa Rosa-based nonprofit HMO that served about 100,000 people in Sonoma County before it went bankrupt and closed several years ago.

The five members of the 4-year-old Northern California Healthcare Authority are Palm Drive Healthcare District; Sonoma Valley Health Care District; North Sonoma County Healthcare District, which oversees Healdsburg District Hospital; Mendocino Coast Healthcare District; and the South Humboldt Community Healthcare District.

The Regional Access Plan is an agreement between Sonoma County’s independent hospitals to seek relationships that drive down costs and offer more services.

Members of the Marin-Sonoma IPA include physicians associated with Marin General, Novato Community, Sonoma Valley, Petaluma Valley, Palm Drive, Healdsburg District and Santa Rosa Memorial hospitals.

Perhaps the most attractive element for the health care authority, also known as the Joint Powers Authority, is Western Health Advantage’s location, existing members and similar health care landscape, Mr. Doss said.

“They have been able to offer viable, successful alternatives along the I-80 corridor – meaning they have been able to offer a product where Kaiser and Sutter have profiles,” Mr. Doss said.

Western Health Advantage didn't return messages for comment.

When what was then just the Marin IPA significantly expanded into Sonoma County in April, Mr. Doss, who coordinated support among the district hospitals, said the demise of Health Plan of the Redwoods in 2002 created a significant hole for anyone wishing for an alternative to Kaiser Permanente.

Western Health Advantage serves some 75,000 members, according to its website.

Its network of health care providers stretches from Solano County to the Sacramento area. The network includes UC Davis Health System, NorthBay Healthcare, which has hospitals in Fairfield and Vacaville, and Woodland Memorial Hospital, which is affiliated with Catholic Healthcare West, according to Mr. Doss.

“I think it’s the beginnings of or a more formal outreach to see what might be available,” Mr. Doss said.

Any further speculation would be premature, he said.