A plan by Kaiser Permanente Northwest to move 1,000 elective surgeries away from other hospitals to its own Sunnyside Medical Center in Clackamas, Ore., is raising concerns for leaders at Vancouver-based Southwest Washington Medical Center.
Joe Kortum, president and CEO of Southwest, said the move could cost Southwest “millions” of dollars in revenue. It also places a burden on Clark County residents who are insured by Kaiser, Kortum said, because it forces them to drive to Clackamas rather than having their surgery performed closer to home at Southwest.
“It’s very disappointing to us,” Kortum said.
Kaiser officials see it differently. Andrew McCulloch, president of Kaiser Permanente Northwest, said the 1,000 surgery cases that would be moved to the Sunnyside facility represent less than 5 percent of the patient admissions that are expected to occur this year at the five hospitals Kaiser contracts with in the region.
The impact “isn’t that significant,” McCulloch said. Moreover, he said, “there has never ever been any edict at Southwest or at another of our network hospitals to mandate that all patients should be moved to a Kaiser facility, because it’s impractical.”
The flap comes at a time of big changes in health care, with looming federal health reform and local hospitals striving to cut costs and become more efficient. It also reveals a dispute between two health care organizations with a long-standing relationship in the region.
An estimated 124,000 people in Clark and Cowlitz counties receive their health insurance through Kaiser, a nonprofit health-care consortium. And Southwest’s capacity to grow in the region just got bigger with the nonprofit’s recent agreement to merge with PeaceHealth, which also runs Longview’s St. John Medical Center.
Differing views
Dave Northfield, a spokesman for Kaiser, said that while the nonprofit does “have a desire to move cases from Southwest to Sunnyside,” it’s the patient who finally decides where to have a surgery.
“It’s not a policy or a directive,” Northfield said of the plan, which would drive costs down for Kaiser. “Anybody who wants a procedure at Southwest can still have it done there.”
That’s not how Southwest officials understand the situation. They said they believe Kaiser has essentially ordered Kaiser-based surgeons who perform work at Southwest to send their patients to Sunnyside Medical Center. They said they base that view on a meeting held in December that included Kaiser doctors and administrators, and Southwest administrators.
Dr. Alden Roberts, chief medical officer for Southwest, said that at that meeting, Kaiser confirmed that its surgeons “had been instructed” to move 1,000 surgery cases to Sunnyside. Kortum said he understands Kaiser’s plan is to take effect April 1.
Discussion under way
For now, Kortum said, he’s talking with McCulloch and “trying to understand why this has happened in our relationship.” Kortum added, “Let me just say we haven’t had a meeting of the minds.” In a contract negotiated last fall, Southwest gave Kaiser “a significant discount in recognition of the (patient) volume that they bring here,” Kortum said.
McCulloch said that moving surgeries to Clackamas might affect Southwest, but the impact could turn out to be very small, particularly if Kaiser increases its pool of insured people, thus providing more opportunities for people to seek services at Southwest.
Northfield said the plan to move some surgeries to Sunnyside doesn’t just affect Southwest and is rooted in Kaiser’s larger effort to provide services under Kaiser’s umbrella, which is more efficient and less expensive to the nonprofit insurer.
Dr. Robert Douglass, a Kaiser surgeon based in Vancouver who does the bulk of his work at Southwest, said, “Nobody has told me yet that I cannot do things at Southwest.” Douglass also has privileges at Sunnyside.
A ‘gradual’ move
Northfield said the movement of surgery cases to Sunnyside will be gradual. He said Sunnyside offers state-of-the-art facilities, which Kaiser developed with more than $350 million in investments over the last couple years.
In 2009, for example, the 53-acre Sunnyside hospital opened a cancer care center and a center for heart and vascular care. The hospital also has an extremely low rate of post-surgical complications and infections, Northfield said.
Roberts, the chief medical officer for Southwest, said Sunnyside “is not any better than our facility.” Kortum said Southwest offers a comprehensive ranges of services and receives high patient satisfaction ratings.
Kortum said he believes Kaiser, when it markets its health plans to Clark County residents, has benefitted from being able to tell them they can use nearby Southwest for their medical needs. He is skeptical that patients will be allowed to choose Southwest rather than Sunnyside. “Is that going to be a real option?” he said.
McCulloch said the issue has been overblown and that Kaiser’s partnerships with other hospitals, including Southwest, are intended to do what’s best for a patient in a given case. “Southwest has been a valued partner in the Vancouver area for many years, and we hope for many years to come,” he said.
Aaron Corvin: 360-735-4518 or aaron.corvin@columbian.com.
