Wednesday, Feb. 9, 2005 | 10:56 a.m.
The Las Vegas Valley's two largest hospital operators agreed to new rate contracts with a coalition that represents about 320,000 people, leaving one hospital operator in negotiations.
HCA Inc., owner of Sunrise, MountainView and Southern Hills hospitals, reached an 11th-hour deal with the Health Services Coalition, which represents unions and employers of firefighters, police officers, teachers, construction workers and hotel and casino employees. Contract extensions were scheduled to expire at midnight Tuesday.
"Everybody stayed at the table all day yesterday and were very active about trying to get an agreement that will help the coalition's members and our patients," said Amy Dirks Stevens, vice president of business development for HCA's Las Vegas market. "We were able to arrive at a solution that worked for all parties."
Earlier Tuesday, the coalition, which was formerly called the Health Services Purchasing Coalition, reached a deal with Universal Health Services Inc., owner of Desert Springs, Valley, Summerlin and Spring Valley hospitals.
The coalition is "grateful to Gov. (Kenny) Guinn, who burned the midnight oil with us and was instrumental in bringing about the results," said Andy Brignone, lawyer for the coalition and some of its members. Guinn also intervened in negotiations in 2002 when the coalition negotiated its contracts that expired Dec. 31.
Guinn spokesman Greg Bortolin said the governor listened to hospital executives and the coalition and then made suggestions to bring about a resolution.
"Both sides trust the governor as a third party," Bortolin said. "The governor isn't advocating for one side or the other. He's trying to make sure that both sides comes to an agreement."
The hospital operators and the coalition declined to discuss the details of the three-year contracts, in part because negotiations continue with Catholic Healthcare West, owner of St. Rose Dominican Hospitals, Siena and Rose de Lima campuses. A contract extension between St. Rose and the coalition is scheduled to expire Monday night.
"We are guardedly optimistic that we can achieve an agreement with St. Rose as well," Brignone said
Clark County-owned University Medical Center, IASIS Healthcare LLC-owned North Vista Hospital and Boulder City Hospital, owned by the city, agreed to "handshake agreements" last week and retroactive contracts will be signed once negotiations are complete at the other hospitals, Brignone said.
Brignone said the negotiations with each of the Las Vegas Valley hospitals were about hospital rates of less than 10 percent and quality care initiatives.
"This is just the first step in our continuing and increasing efforts to bring affordable health care to our members and quality health care not only to our members but to our community," he said.
Contract negotiations included commitments from the hospitals that they would participate in programs that report and rank quality in various areas of care. Many of the hospitals voluntarily report quality information already.
"There's a lot of opportunity to improve the quality of health care," Brignone said. "Quality is not just a word. It has real consequences for people. You can reduce complications in hospitals, mistakes in hospitals (and) reduce the risk of morbidity."
The coalition has not ruled out other alternatives to health care, which they said last week could include building its own hospital, and plans to work with hospitals to create a better negotiating system for future contracts, Brignone said.
" There's got to be a better way to deal with contracts for the coalition members than to go through this kind of a crisis and this kind of angst every three years," he said.
The Health Services Coalition is the only health-plan negotiator that could soon have contracts with all of the Las Vegas Valley hospitals.
"The coalition is the largest payor group in Southern Nevada," Brignone said, adding that his group represents about 20 percent of the local population. "Those numbers give us bargaining strength."
Despite the coalition's bargaining strength, some state legislators say they plan to introduce legislation that would even the hospital-payor playing field because coalition members were getting a bad deal.
"That group in this last round was seen as not having a great deal of negotiating clout," Assembly Speaker Richard Perkins, D-Henderson, said. "Groups like Sierra (Health Services Inc.) and others seem to have more clout in their negotiations of rates that were requested."
The Assembly Health and Human Services Committee is holding an emergency meeting Thursday night to discuss hospital negotiations, hospital cost-containment legislation and a reinvestment act for health care providers. The meeting was announced Tuesday afternoon by Assemblywoman Sheila Leslie, D-Reno, who called the lack of contract agreement "an impending health care crisis."
The meeting will be held even though the majority of the hospitals have reached agreements with the coalition, Perkins said.
"We had this problem three years ago," Perkins said of the contentious negotiations. "Our goal is to find some way to create an environment where we don't have this every three years."
He said legislators should consider cost-containment legislation, similar to the laws imposed on Nevada hospitals in the mid-1980s.
"My preference is to let the markets work things out, but in this situaiton the markets don't seem to be working," Perkins said.
Perkins plans to introduce a bill that would require Nevada health care providers to reinvest a portion of their profits into the local community before sending millions of dollars to out-of-state corporate offices.
The proposal would be modeled after the federal Community Reinvestment Act that requires banks to make a percentage of their loans -- roughly 60 to 70 percent -- within the communities in which they accept deposits.
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