Hospital Officials Open to HMO Idea

Community Memorial Hospital officials are open to the idea of extending the county’s managed health care program to tens of thousands of working poor in the county who are uninsured, a spokesman for the private hospital said Tuesday.

But that coverage would need to include visits to private doctors and hospitals as well as county-run health care facilities, the officials said.

“There needs to be some public-private partnership for people who are underinsured,” Community Memorial spokesman Mark Barnhill said. He said Michael Bakst, Community Memorial’s executive director, who was initially silent about the idea, is “hopeful there is a window of opportunity here to come up with a collaborative plan.”

Supervisor Frank Schillo recently asked county Chief Administrative Officer Harry Hufford to study the possibility of opening the county’s HMO--which now covers roughly 3,000 county employees and their family members--to include lower-paid employees of small businesses that don’t provide health insurance.

Officials representing private doctors, hospitals and insurers have cautioned there would be a backlash if the county’s plan were to be seen as a means of cutting into the private health care sector. Supervisors expected resistance from Community Memorial in particular, given the contentious relationship between the Ventura hospital and neighboring Ventura County Medical Center. In recent years, Community Memorial has repeatedly accused the public hospital of trying to cut into its business.

Their battle culminated most recently in a Community Memorial ballot measure that would have transferred the county’s $260-million share of a national tobacco settlement into the hands of private hospitals.

That measure failed last month, but the county had already made a peace offering, passing an ordinance dedicating the tobacco settlement to health care and committing a portion of the money to private health care providers. The details have yet to be worked out.

Barnhill said Tuesday talks between the county and private hospitals over that ordinance could provide “a framework for starting those discussions” on insuring the working poor.

Schillo has said the county can offer basic health insurance at a lower rate than private insurers, particularly if it limited visits to county facilities. That could make insurance affordable for small companies and low-income workers who are not poor enough to qualify for state or federal subsidies. But Schillo’s theory could require months of research before a plan could be developed.

The county has yet to study how many people might want such insurance--perhaps 40 times the current HMO membership--and what sort of chronic conditions that pool of people might possess. Until officials know such details, they can’t begin to guess what rates they would need to set in order to keep an expanded HMO afloat, said Mark Gregson, interim chief executive officer at Santa Paula Memorial Hospital.

“It’s a noble effort,” Gregson said. “But there are substantial [public] dollars at risk.”