North Bay Business Journal

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.

NOVATO — The Meritage Medical Network today was approved as an accountable care organization under a Medicare initiative stemming from the new health care law.

PETALUMA — The Petaluma Health Center today said it received $500,000 in federal funds and plans to open two new health centers at Petaluma high schools next year.

PETALUMA — Redwood Community Health Coalition was awarded $1.2 million in federal funds to help expand use of health information technology.

With full implementation of the health care law on everyone’s mind, from providers to insurers to employers, federally qualified health centers have long been viewed as a critical piece of expanding access, many of them anticipating an influx of new patients and thus an increase in services.

But while the Affordable Care Act will add significant funding for the nonprofit health sector, such health centers are rapidly evolving on their own, in part to address changes in health care but also in response to increasing demand, according to North Bay health center executives.

PETALUMA — Redwood Community Health Coalition recently took part in a pilot project testing a mobile health application that enrolls patients in public assistance programs, a potentially pivotal development for the public health sector. The accelerating convergence of mobile technology and health care will likely open new avenues of access to underserved populations, which could in turn help states with implementing key pieces of health care reform, officials said.

SANTA ROSA — Sutter Health will expand its Advanced Illness Management initiative into Sonoma County, marking the fist major expansion of the program that focuses heavily on late-stage chronic illness and best treatment options for such conditions.

Narrow networks are coming to the North Bay.

Blue Shield of California will launch its SaveNet HMO in Marin and Sonoma counties in 2013, forming a narrow network around Novato-based Meritage Medical Network and Sonoma County Primary Care.

Western Health Advantage formally filed plans with the state to be a part of Covered California, the state’s online health exchange that will go live in 2014 as part of the federal health care reform bill, the Affordable Care Act. …

On the federal level, the Obama Administration last week issued a host of new rules and details on how insurers can structure benefits and premiums beginning in 2014. …

Fireman’s Fund Insurance Company announced the appointment of Travis Bethune to the position of vice president, distribution management and services leader. …

The political and legal challenges to federal health reform may finally be settled with the reelection of President Obama and the Supreme Court’s upholding of the Affordable Care Act, but, even with that seeming sense of finality, a host of challenges lay ahead for all levels of the industry.

David Hodges recently merged his own brokerage into Vantreo Insurance Brokerage, becoming vice president of employee benefits after operating independently for nearly 30 years in the North Bay. He has focused exclusively on employee benefits during that span.

Todd Salnas was appointed president of St. Joseph Health, Sonoma County in July 2012, overseeing operations for Santa Rosa Memorial and Petaluma Valley hospitals, as well as a variety of non-acute care services throughout the county. Mr. Salnas, 39, joined St. Joseph Health in 2009 and previously served as executive vice president and chief operating officer for Sonoma County.

Rick Heron is chief marketing and brand officer for Western Health Advantage, a Sacramento-based HMO that recently received approval to expand into Marin, Sonoma and Napa counties. The move into the North Bay for the nonprofit HMO is a significant development for a number of providers and brokers alike, who have said the injection of another health plan will offer more choice — and thus more competitive pricing, it is hoped — for the region’s employers and individuals. Mr. Heron has been with Western Health Advantage for seven years.

Dennis Lum is vice president of channel strategy, sale operations and performance for Kaiser Foundation Health Plan. His current areas of focus include broker strategy, broker development, and execution for health care reform and private exchanges, among other areas. He began his career with Kaiser by managing the Proposal Development Department for Northern California.

Mike Purvis is the chief administrative officer for Sutter Medical Center of Santa Rosa, an affiliate of Sutter Health. Mr. Purvis has been with Sutter in Santa Rosa for the past three years, helping to lead health systems’ efforts in rebuilding and relocating its current Chanate Road hospital to a $284 million facility on Mark West Springs Road just north of Santa Rosa.

Victor McKnight is a principal with EPIC Insurance Brokers & Consultants in Petaluma, where he oversees employee benefits. Mr. McKnight, a North Bay insurance veteran with more16 years experience, has represented both employers and carriers, and has lobbied in both Sacramento and Washington, D.C.

The Meritage Medical Network, formerly known as the Marin-Sonoma IPA, has officially made known its plan to earn accountable care organization, or ACO, designation by the Centers for Medicare and Medicaid under the Affordable Care Act of 2010. …

Mendocino Coast District Hospital, a 25-bed nonprofit critical access facility, is seeking bankruptcy court protection from creditors as it seeks to reorganize its debts while keeping the doors open. …

Evan Rayner, Healdsburg District Hospital chief executive officer, is stepping down from his position, according to the North Sonoma County Healthcare District, which owns and operates the 43-bed hospital. …

SANTA ROSA — Santa Rosa Community Health Centers recently opened its eighth location, Roseland Pediatrics, in the southwest area of the city, where the federally qualified health center said it now offers care for newborns, children and teens.

West County Health Centers has been selected as one of 30 primary care providers across the country that will be part of a best-practices project by the Robert Wood Johnson Foundation, aimed at identifying providers that maximize their workforce to improve health care delivery.

Woodruff-Sawyer & Company recently announced the launch of BizInsure, a website that aims to make shopping for commercial insurance easier. …

Enrollment in Medicare Advantage plans is expected to increase by 11 percent in the next year, and premiums will remain steady, according to the U.S. Department of Health and Human Services. …

The National Committee for Quality Assurance ranked Kaiser Permanente Northern California as the eighth-best commercial plan in the country and the third-best Medicare plan in its most recent survey, Kaiser announced recently. …

Gov. Jerry Brown recently signed Assembly Bill 53, which requires the state’s top 200 insurance companies to report on their efforts to procure goods and services from businesses owned by minorities, women and disabled veterans. …

The California Legislature recently agreed to shift some 880,000 lower-income children from the Healthy Families program to Medi-Cal, which reimburses providers at a lower rate. That would reduce annual patient reimbursement to Santa Rosa Community Health Centers and West County Health Centers. …