Hearing will examine cuts at Stanislaus County health agency

Stanislaus County supervisors voted Tuesday to set an Oct. 16 public hearing to consider cuts to health care services and authorized staff to pursue other cost-saving measures to deal with a $12.6 million shortfall at the Health Services Agency.

The county board will hold the public hearing to consider:

Reducing hours at the urgent care center on Scenic Drive in Modesto from 84 to 36 a week. Instead of being open 12 hours daily, it would operate from 5 to 9 p.m. weekdays and noon to 8 p.m. on weekends.

Eliminating clinical laboratory and radiology services

Lowering the maximum income eligibility for the medically indigent adult program

The changes, if approved, could take effect Dec. 1.

Other measures to contain costs are designating a single clinic to serve medic-ally indigent adults, requiring co-pays of some of them, and renegotiating commercial insurance contracts to get higher payments for patient visits.

The county expects later this week or next week to receive a federal designation for its clinics that would increase reimbursements for Medi-Cal and Medicare patient visits and erase about half the shortfall.

A report from HFS Consultants listed 20 other initiatives for cutting $6.2 million more in expenses. The county hired the Oakland-based consultants in July to address the annual deficits at the Health Services Agency, which has served about 80,000 low-income patients a year.

Although the majority of those patients are covered by Medi-Cal and other government programs, about 10 percent have private insurance through Kaiser, a Blue Shield PPO or a Blue Cross PPO. Those insurers often pay the clinics $50 to $60 for patient visits. The county will negotiate for higher rates and may terminate contracts if it doesn't get them.

Officials stressed the action does not affect the many patients in the Blue Cross and Health Net Medi-Cal managed care plans.

The agency will talk with the Children and Families Commission about increasing payments for Healthy Cubs, which offers prenatal care to women and outpatient services to children up to age 5. It serves nearly 2,500 patients.

The agency's radiology and lab services may be cut because patient volumes have been falling without a drop in county costs. The Health Services Agency will have to contract with outside businesses to provide blood tests and imaging scans for medically indigent adults. Medi-Cal and Medicare patients who have used the county services will have to go to providers in the community.

Will accept more patients

A manager for one imaging center said it can accept additional Medi-Cal patients, even though the state program pays significantly less for radiology services than private insurers.

"Those patients are going to have to be taken care of somewhere in the community and we are certainly willing to help out," said Julie Ferriera, regional operations manager for Radnet Inc., owner of Modesto Advanced Imaging.

She said the Medi-Cal payment for a chest X-ray is $25.98. A Blue Cross PPO pays $39.77. For a pelvic ultrasound, the Medi-Cal rate is $67.65; Blue Cross, $106. Ferriera said imaging centers can serve Medi-Cal as long as there is a balance of government insured and privately insured patients.

The loss of county radiology will mean that Golden Valley Health Centers, a safety net provider with primary care clinics in the county, will have to make other arrangements for uninsured patients who need an X-ray or ultrasound, said Christine Noguera, deputy executive officer for Golden Valley.

Golden Valley refers those patients to the Health Services Agency under a contract with the county.

"It is a very common referral and our patients know that system and utilize it well," she said. "I am concerned this is going to affect access to radiology services for our patients."

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.