North Bay Business Journal

PETALUMA — The American arm of Danish ambulance giant Falck, one of the largest ambulance companies in the world, has acquired Petaluma-based Verihealth Inc., an ambulance and medical transport company founded in 2000.

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.

NOVATO — The Marin Community Foundation today said it will distribute to local health clinics $2 million in new grants from the Sutter Health Access to Care Fund.

CLOVERDALE — Alexander Valley Regional Medical Center recently filed for designation as a federally qualified health center, a move that, if approved, would allow Sonoma County’s only certified rural health clinic to receive significantly better reimbursement rates and more operating revenue.

As the Affordable Care Act looms large on the minds of health care providers, lawmakers and providers are increasingly calling for less stringent limitations on non-physicians in order to meet demand spurred by the forthcoming influx of new patients.

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?”

Business owners, particularly in the wine industry that makes up a significant proportion of the North Coast economy, need to pay attention to major health care insurance, tax and estate law changes this year to avoid steep noncompliance penalties and mitigate significant tax increases, according to local tax-planning and insurance experts.

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.

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.

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.

GREENBRAE — Marin General hospital, the county’s largest provider of acute-care services, has undergone rapid change in the past three years, having shifted away from Sutter Health to an independent district. But perhaps its biggest and most important challenge still lay ahead, as the 235-bed facility seeks to entirely rebuild itself in order to meet state compliance with seismic safety measures.

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.

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.

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.

Partnership Health Plan of California, a Fairfield-based managed Medi-Cal plan, has petitioned the state for further expansion, hoping to include Lake and six other Northern California counties, in addition to the six North Coast counties already in its network. …

Woodruff Sawyer & Co. of Novato is holding an seminar to discuss health care reform for employers, with subject matter including compliance with the Affordable Care Act, the California State Exchange and private exchanges, benefit design strategies, major employer issues for 2014, and other matters. …

Kristina Keck has joined Woodruff-Sawyer & Co. in the firm’s employee benefits practice as account executive, retirement plans. …

Covered California, the state’s insurance exchange set up under health care reform, plans to provide grants totaling $43 million for community groups to help spread the world of the exchange and how it will work. …

Insurance experts have questioned whether the penalty levied on individuals and business for not obtaining health insurance as part of the Affordable Care Act would be enough of an incentive, but a recent report in the Journal of the American Medical Association found that would be. …

As full-scale implementation of health care reform nears ever closer, looming heavy on the minds of employers, insurers and health care providers, questions continue to swirl around numerous key issues, with California’s online health exchanges high among the heart-burn causing measures.