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27 January 2011

California Edition

Calendar Katz Outlines Remaking Of LAC DHS


Vows to Overhaul Healthcare Delivery And Culture

February 9 When Mitchell H. Katz, M.D., made one of job on Jan. 3, and is paid an annual salary of
his rst public appearances after assuming the $355,000. He had been the Supervisors’
helm of the Los Angeles County Department unanimous pick to replace Bruce Chernof,
<3/*0!9441(2!'(22/(=/.)!8(*)!8-4>)*)4?)@! of Health Services earlier this month, he M.D., who left the post in May 2008.
'(?/>/?!'(2H+!E-=)2!(40!8-4>)*)4?)! possessed features never seen by his The 51-year-old Ivy League-trained
8)4=)*6!8/=&!->!N401+=*&@!T/22!0/+?1++!=3)! predecessors: a multi-day growth of beard, physician had been head of the San Francisco
1+)!->!-1=D(=/)4=!?(*)!(40!/4=)5*(=)0!
+&=)H+6!(H-45!-=3)*!=-D/?+@!I"##LI"Q#@!! green khakis, tennis shoes, a Department of Health since
loose tie and a blue blazer 1997. He has been widely
82/?C!E)*)!M-*!A-*)!N4>-*H(=/-4 whose vents were resolutely lauded for establishing
pinned together. Healthy San Francisco, the
And while Katz’s nation’s rst universal public
presentation at the California health insurance plan.
February 23 Endowment on Monday “While Dr. Katz has
began with his hugging its experience in running a major
President Robert K. Ross, urban public healthcare
98:+;!<3)!).-21=/-4!->!3)(2=3?(*)! M.D., before taking the system, he also has the vision
0)2/.)*&@!A(**/-==!B1*%(4C!9/*D-*=!E-=)2@! podium, he nonetheless laid Mitchell H. Katz, M.D., speaking and passion to steer the L.A.
FD-4+-*)0!%&!=3)!8(2/>-*4/(!9++-?/(=/-4!->! out an agenda that was Monday in Los Angeles. County Department of Health
E)(2=3!'2(4+6!=3/+!).)4=!140)*=(C)+!(! anything but mellow: he Services to meet the
=)?34/?(2!./)G!->!98:+!>*-H!=3)!D(&)*!
+=(40D-/4=@!IJKLI"##. wants to remake the nation’s second-largest challenges and opportunities posed by
public health system and overcome the national health reform,” said Los Angeles
82/?C!E)*)!M-*!A-*)!N4>-*H(=/-4 sometimes rigid bureaucracy that likely played County Supervisor Zev Yaroslavsky.
a role in keeping the post vacant for nearly Katz, who spoke for only 15 minutes but
two years. elded questions from the audience for about
February 24-25 “Is there a structural reason that Los an hour, laid out his plans for DHS in the
Angeles County can’t have the best safety net coming months and years.
system in the country?” Katz asked the He observed that the recently approved
audience, primarily members of the Los Medi-Cal waiver and impending federal
9441(2!E)(2=3?(*)!M-*)?(+=!8-4>)*)4?)@!
F?3--2!->!O45/4))*/456!P4/.)*+/=&!->! Angeles Chamber of Commerce. “The answer healthcare reform – which are expected to add
8(2/>-*4/(6!N*./4)@!M-*)?(+=+!->!3-G!=3)! is no. The point is, we have to gure out millions of Californians to the Medi-Cal rolls
3)(2=3?(*)!/401+=*&!G/22!>(*)!>*-H!%-=3! where we want to go.” and could have Medi-Cal managed care plans
D*/.(=)!+)?=-*!(40!5-.)*4H)4=!->>/?/(2+@! Katz, appointed by the L.A. County Board
IQKKLIRSK@! of Supervisors in December, began his new
Continued on Next Page
82/?C!E)*)!M-*!A-*)!N4>-*H(=/-4

E-Mail
info@payersandproviders.com with
the details of your event, or call
(877) 248-2360, ext. 3. It will be
published in the Calendar section,
space permitting.
www.lakesidecommunityhealthcare.com

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Payers & Providers NEWS Page 2

Top Placement... Katz (Continued from Page One)


Bottomless Potential competing for new enrollees on the state-run However, Katz also conceded that his
insurance exchange – would change the roles early proposals have already run up against
Advertise Here and perceptions of safety net providers. the near-legendary force of the county
“The safety net will be functioning as a bureaucracy.
(877) 248-2360, ext. 2
system of choice, not a system of the last “My staff has told me that proposals I
resort,” he said. have made that would improve quality and
As a result, Katz discussed assigning not cost any more would not work,” he said.
In Brief patients who enter the county system to
specic hospitals or clinics, along the lines of
“I’ve been told the (Los Angeles) County
Counsel won’t let us, the unions won’t let us,
patient-centered medical homes. He noted and the board (of Supervisors) won’t let us.”
that under the Healthy San Francisco plan, He added that the notion of moving forward is
enrollees are required to pick a clinic to perceived by some as foolish.
receive their primary care. Instead, Katz said he would remake his
IHA Wins RWJF Grant
“You were accountable for choosing a agency’s outlook.
For P4P Enhancement clinic for your care,” he said, noting that one “A cultural change is the single biggest
of the primary picks here for indigent care – thing I have to do at DHS,” he said.
The Oakland-based Integrated
the emergency room at Los Angeles County- Katz is already mounting another cultural
Healthcare Association has been
awarded a $281,000 grant from the USC Medical Center, was not appropriate. challenge toward the attachment Angelenos
Robert Wood Johnson Foundation In responding to a question from a have for their cars. He bicycles daily to and
to work with the Santa Monica- nurses’ union ofcial, Katz said he wanted to from from his mid-Wilshire apartment at the
based RAND Corp. to create an reduce some of the authority physicians have Park La Brea complex to his ofce
advanced program to better gauge
the quality of healthcare delivery. in DHS and share more of it among nurses downtown. It’s a one-way trip of nearly eight
The new program, focused on and other allied healthcare professionals. miles in often heavy trafc, and likely explains
pay-for-performance programs, will “Registered nurses are the glue of any many of his wardrobe choices.
attempt to estimate a physician healthcare system...the notion that a doctor “He has found 6th Street to be a good
group’s total cost of delivering care.
leads treatment is wrong,” said Katz, who way to go,” said DHS spokesman Michael
It is intended to enhance IHA’s
current pay-for-performance added that nurses often are in far closer Wilson, although he added that Katz has
program. communication with the patient. “A high- already complained of several near misses
“Building on the foundation of performing system is one that is multi- with motorists. How he fares in potential job-
our pay for performance program, professional.” related collisions remains to be seen.
this effort will merge both quality
and cost measures to create a more
comprehensive view of

DMHC Reduces Many Penalties


performance,” said IHA Executive
Director Tom Williams. “Carefully
constructed, the results will enable
physician groups to differentiate
themselves and for health plans to Fines Levied in November Cut By More than $1M
make value based contracting
decisions that benefit consumers
and reward high-performing
providers.” The Department of Managed Health Care amount with a “back ne” if the plans do not
A statement issued by the IHA held a press conference in November to show full compliance during their next routine
said that the enhanced program announce that it had ned seven health plans audits, which would occur within 18 months.
should be ready to deploy by 2012. $4.85 million for failure to pay provider The biggest beneciary was Anthem Blue
claims and answer their complaints in a Cross of California. Originally ned
timely manner. $900,000, the sum was reduced to $500,000,
Kaiser To Deploy Fuel However, nal settlement letters posted a 55% reduction. Aetna had its ne cut in
Cell Techonolgy At on the agency’s website in recent days show half, to $150,000 from $300,000.
Facilities that the regulator provisionally reduced the UnitedHealth/PaciCare had its ne reduced
nes levied against ve of the plans, some by to $500,000 from $800,000. Blue Shield of
Kaiser Permanente has entered into
more than half. California had its ne reduced 33%, to
an agreement with Sunnyvale-based
Bloom Energy to install fuel cells at To date, the DMHC reduced the nes – $400,000 from $600,000.
seven of its facilities in California known as administrative penalties – by $1.3 Kaiser Foundation Health Plan had its
by the end of this year. million, an overall reduction of nearly 27%. A ne reduced to $500,000 from $750,000, and
The cells are expected to letter of agreement has yet to be posted for reclassied as a contribution to DMHC’s
generate four megawatts of
electricity combined, and reduce Woodland Hills-based Health Net, which Managed Care Fund.
was ned $750,000. The letter to Kaiser indicated the health
A DMHC spokesperson said the nes plan was willing to ght the violations the
Continued on Page 3 announced in November were initial
penalties, which could return to the full Continued on Next Page

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Payers & Providers NEWS Page 3

Longer ALOS!* DMHC (Continued from Page Two)


Advertise Here DMHC claimed it had committed, and that DMHC acted on its own to reduce the nes.
the settlement was reached in the best A Kaiser spokesperson said the plan would
(877) 248-2360, ext. 2 interests of both parties to avoid “the comply with the objectives set forth by the
uncertainty and expense of an administrative DMHC.
*For our ads, not your hospital hearing.” Only Cigna agreed to pay its full ne of
The letters to the other plans indicated the $450,000.

In Brief
LETTER TO THE EDITOR
the use of fossil fuels at the sites by
slightly more than a third. They We want to set the record straight about an currently under construction. !More than $3
will initially be operated on natural opinion article that unfairly charged the billion in hospital projects have also been
gas, although they may be operated
Ofce of Statewide Health Planning and approved by OSHPD, and they would
on methane gas derived from
landfills or manure. Development (OSHPD) with holding up certainly generate jobs and help revitalize
"Kaiser Permanente recognizes hospital construction projects in California (“Is communities, but for reasons completely
the health of the environment OSHPD an Obstacle to Growth?,” Jan. 20). It’s outside the state’s control, these projects sit
directly affects individual and simply not accurate to say that the state is idle. !!Further, OSHPD’s efforts can only
community health," said Kathy
Gerwig, vice president and impeding growth when billions of dollars in address half of the length of time it takes to
environmental stewardship officer projects have been approved but are stalled approve a plan, as plans are typically with the
at Kaiser Permanente. "By because of inaction by hospital builders, not builder’s design team 50%-60% of the time
expanding the use of cleaner anything the state has done. during the plan review process. Design teams
energy technologies such as fuel
Unsafe hospital buildings can kill people need to hold up their end of the bargain as
cells, we're demonstrating our
commitment to greening our during earthquakes. Further, these buildings well, returning plans back to OSHPD in a
energy portfolio and reducing our are expected to withstand an earthquake so timely way so we can turn them back around
carbon footprint." that they can remain open to treat the injured as quickly as possible.
during such a disaster. We will continue to We stand by our record of assisting
insist that hospitals buildings are built to save hospitals to design and construct buildings
Wright Joins Payers &
lives, and we are doing everything in our that will ensure public safety in California,
Providers Editorial power to expedite the state approval process. which has the most active and heavily
Board OSHPD has implemented numerous populated seismic zones in the nation. We
enhancements, such as expedited plan review hope that hospitals will take steps to
Anthony Wright, the executive procedures, launched a Web-based tracking commence construction of the projects that
director of Oakland-based Health
system, implemented urgency regulations have already been approved, and continue to
Access California, has joined the
editorial board of Payers & allowing hospitals to take advantage of work in partnership with us to move plans
Providers’ California edition. alternative seismic compliance options, and forward quickly and effectively.
The addition of Wright, who is worked collaboratively with entities
based in Sacramento, makes him authorized to use the Design-Build model as a David M. Carlisle, M.D., PH.D.
the second Northern California to
join the editorial board. method to speed project delivery. !Over $5.5 Director, Ofce of Statewide Health
Established in 1987, Health billion of OSHPD approved projects are Planning & Development
Access has advocated on a variety
of health issues for consumers in
California, particularly the
expansion of healthcare coverage COO/CFO COMPENSATION
for its more than 8 million
residents who lack insurance.
Wright, who previously served
A PAYERS & PROVIDERS EXCLUSIVE WHITE
on the staff of Vice President Al
Gore, has headed Health Access PAPER
since 2002. He is a graduate of
Amherst College. COMPENSATION ON NEARLY 200 OF CALIFORNIA’s
“Anthony is one of the most
distinguished and measured voices HEALTHCARE COOs & CFOs NOW AVAILABLE
for advocacy in California, and I
am extremely pleased that he is
joining the board,” said Payers &
Report is $149. Report and Salary Data is $275.
Providers Publisher Ron Shinkman.
“His contributions to the op-ed
Call (877) 248-2360, ext. 2
page will lay out specific advocacy OR
issues to a policy-oriented
audience.” CLICK HERE to Order

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Payers & Providers OPINION Page 4

9-21:)!;6!<++1)!=
Our Fear-Driven Regulatory Realm
'(&)*+!,!'*-./0)*+!/+! One Event, Not Day-to-Day Reality, Pushed SB 1953
>1%2/+3)0!).)*&!?31*+0(&!%&!
'(&)*+!,!'*-./0)*+!'1%2/+3/456!
778@!A4!(441(2!/40/./01(2! As the CEO of a small Los Angeles County though the aftereffects on the families of
+1%+B*/>C/-4!/+!DEE!(!&)(*! hospital who has dealt in the past with the those who die from these understated killers
FD$=E!/4!%12G!1>!C-!$#! Office of Statewide Health Planning and are no less devastating.
+1%+B*/%)*+H@!<C!/+!0)2/.)*)0!%&! Development, I read Jim Lott’s recent Similarly, when fear of catastrophe sets
)I:(/2!(+!(!'JK!(CC(B3:)4C6! opinion “Is OSHPD an Obstacle to the tone for policy, funding is often funneled
-*!(+!(4!)2)BC*-4/B!4)L+2)CC)*@ Growth?’ with great interest. Mr. Lott’s away from its most deserving targets. The idea
astute recap of both the potential behind SB for SB 1953 came about after a 6.7 magnitude
1953’s initial design and the corresponding earthquake in Los Angeles County, California
shortcomings in its deployment killed 72 people in January 1994.
A22!(0.)*C/+/456!+1%+B*/%)*!(40! was in my opinion insightful. Seventeen years later, hospitals
)0/C-*/(2!/4M1/*/)+N However, to cast the blame across California are spending
entirely on OSHPD is not their part of the estimated $90 to
FOPPH!"=OI";Q# necessarily fair, especially when $120 dollars to ensure they meet
/4R-S>(&)*+(40>*-./0)*+@B-: it comes to state-mandated the seismic safety requirements
seismic safety standards. In mandated by the state legislature,
T(/2/45!(00*)++N
marshaling all California regardless of their day-to-day
O$O!U@!V-22&L--0!W(&6!X1/C)!Y hospitals in the direction of SB fiscal health. While the
Y1*%(4G6!8A!E$Z#Z 1953, OSHPD has been charged Northridge Earthquake
with a Herculean task, which has unquestionably caused
W)%+/C) been compounded by our current tremendous damage to Southern
LLL@>(&)*+(40>*-./0)*+@B-: economic climate. With such California, the proposed price tag
K(B)%--G responsibility thrust upon the By Craig when broken down runs about $1.7
shoulders of an underfunded,
LLL@R(B)%--G@B-:[>(&)*+>*-./0)*+
understaffed department, efficiency
B. Garner billion per fatality.
As an administrator, it is confusing to
?L/CC)*
LLL@CL/CC)*@B-:[>(&)*+>*-./0)*+ was certainly never a priority in the me that America’s healthcare is so
minds of its makers. Furthermore, as often dictated by the aftereffects of an
important as this role may be, upon aberrant, high profile tragedy, while more
reflection it stems in large part from the subtle yet more prolific killers go largely
fear generated by a high-profile tragedy and unpublicized as their cures remain
\0/C-*/(2!Y-(*0 the arguable overreaction of state underfunded and their victims die without
policymakers and popular media. Too often fanfare, or essential earmarked funds are
XC).)4!?@!9(2)4C/4)6!'*)+/0)4C6! after these events the course of healthcare rerouted to assuage tomorrow’s fears.
?3)!8(:0)4!]*-1>
shifts its aim away from the big picture to Certainly seismic compatibility is a goal
^-++!]-20%)*56!<::)0/(C)!'(+C! dwell on anomaly, often to the detriment of worth attaining, but in these troubled
83(/*:(46!7-+!^-%2)+!V-+>/C(2!,! both patients and providers. economic times as hospitals both large and
T)0/B(2!8)4C)* To be certain, the isolated events that small struggle to keep their doors open to a
capture our attention are often devastating, dependent public, it certainly does not hurt to
A4C3-4&!W*/53C6!\_)B1C/.)! tearing apart families, communities, even understand the origins of this expensive
J/*)BC-*6!V)(2C3!ABB)++!8(2/R-*4/(! cities. In early January an angry, disturbed overhaul, and question whether these funds
young man killed six with his gun. Some of would be better spent on preserving the
V)4*&!7-1%)C6!83/)R!XC*(C)5&! the victims were high profile and others quotidian rather than planning for a possible
`RR/B)*6!a))4(4 were tragically young. As the fallout from catastrophe. By 2015 all functioning
this shooting captured the nation’s California hospitals should be prepared for
spotlight, significant focus centered on the Great Shock, but how many will remain
episodes of unidentified bipolar disorder to be left standing, regardless of the whims of
'1%2/+3)*[\0/C-*I/4I83/)R
and schizophrenia. Mental health experts mother nature?
^-4!X3/4G:(4 trumpet the warning signs of illness leading
)0/C-*S>(&)*+(40>*-./0)*+@B-: to such a violent event much like Craig B. Garner is the chief executive officer
Californians speak of “The Big One,” even of Coast Plaza Hospital in Norwalk.
though less than 0.004% of the U.S.
population is likely to die from firearms
Op-ed submissions of up to 600 words are
each year. When this occurs, the spotlight welcomed. Please e-mail proposals to
is shifted away from more prevalent threats editor@payersandproviders.com,
such as diabetes, obesity, and heart disease,

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Payers & Providers MARKETPLACE/EMPLOYMENT Page 5

MANAGER, BUSINESS ADVISORY SERVICES

The Camden Group has been providing business advisory and management services to the healthcare industry exclusively
since 1970. We have served more than 1,000 clients nationwide. Due to our growth, the following opportunity is available in
our Los Angeles ofce:

Will prepare and manage the following types of projects: strategic plans, physician-hospital alignment strategy (e.g., ACO,
clinical integration, bundle payment), service line development, and demand forecasts for presentation and collaboration with
the executive team members of hospitals, physician groups, and other healthcare organizations. The successful candidate will
have a high degree of direct client interaction, be responsible for managing projects, participate in the business development
and sale of consulting projects, and use their time in a billed-hours environment. Masters degree in business or related eld, 8
years of consulting or hospital-based planning experience required. Los Angeles.

All of our positions require prociency with Microsoft Ofce software, the ability to work well with individuals at all levels of
an organization, and excellent analytical, written, and oral communication skills. Based in Los Angeles, with work locally and
throughout the nation. Comprehensive compensation packages offered.

Contact Information:
Miriam Lupercio, Human Resources
HR@TheCamdenGroup.com
www.TheCamdenGroup.com

MEDICARE COMPLIANCE ADVISOR - ensures that L.A. Care and its subcontracted provider network is compliant with all Centers
for Medicare &!Medicaid federal regulatory requirements. This is achieved by participating in the annual PPG and quarterly audits,
working with internal and external staff to correct performance deciencies, identifying internal areas for improvement, serving as
the compliance contact with Plan Partners for member grievance oversight, provider services oversight, and interpreting CMS/SNP
Program requirements for L.A. Care. ! Additionally, this individual is a resource to internal staff on compliance matters relating to
CMS/SNP standards, including, but not limited to, marketing materials, grievances and appeals, member rights issues, and claims
adjudication.! Responsible for performing internal audits, monitoring for implementation of corrective measures, and interpretation
of CMS requirements. !Working knowledge of federal and state requirements is required, as well as highly developed analytical skills
and excellent verbal and written communication skills.!

For complete job description, qualications/requirements, visit our website: www.lacare.org

To apply, email resume with salary history and requirement to: recruiter@lacare.org referencing “Payers & Providers Ad”

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Payers & Providers MARKETPLACE/EMPLOYMENT Page 6

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*New England Journal of Medicine, 2004.

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Payers & Providers MARKETPLACE/EMPLOYMENT Page 7

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