Coalition looking to avoid another ‘crisis’

Michelle Swafford

Wednesday, Feb. 23, 2005 | 10:51 a.m.

New hospital rate contracts negotiated two weeks ago on behalf of 320,000 Las Vegas Valley workers are just the beginning of many proposed changes to the health care system.

The Health Services Coalition, formerly the Health Services Purchasing Coalition, said the Las Vegas Valley cannot afford to have what it calls another "crisis" in three years when it is time to negotiate hospital rates at each of the Las Vegas Valley's 11 hospitals and Boulder City Hospital.

The coalition is made up unions and employers who represent teachers, firefighters, hotel and casino workers, carpenters, cement masons and plasterers, police officers, electricians, plumbers, convention workers, trash collectors, truck drivers and grocery workers.

"As was the case under the old contracts, we currently have all hospitals under the new contract," said Andy Brignone, lawyer for the coalition and some of its members. "The members of the contract can go to any hospital in Southern Nevada."

The new contract rates increase the cost of the coalition members' health plans, but will not automatically increase the amount workers pay for their health care, Brignone said.

He said the hospital contracts are being signed this week and have different rates and requirements for each hospital. He declined to say how much of a reimbursement increase each hospital would receive from coalition members, but he said most of them are less than 10 percent, which is what the coalition originally requested.

"The ultimate terms of these contracts were closer to our numbers in the end than they were to the hospitals' numbers in the beginning," Brignone said. "We have certain targets that we wanted to meet and we believe we've very close to those targets. That's not to say we're satisfied with the results and therefore go through three years of inactivity."

The contracts accounted for patient types and utilization and cost of services and technology when determining rate increases, he said, adding that all of them are three-year contracts and require hospitals to participate in various quality care initiatives, Brignone said.

Many of the hospitals voluntarily report to quality control groups now.

Hospital operators say they are pleased with the outcomes of the contracts.

"We are pleased to be able to continue to provide excellent health care and to make investments in the future of our community," said Amy Dirks Stevens, vice president of business development for HCA's Las Vegas market. HCA Inc. owns Sunrise, MountainView and Southern Hills hospitals.

Andy North, spokesman for St. Rose Dominican Hospitals, said, "We are pleased to reach an agreement that will allow firefighters, school teachers, Culinary workers and others to have access to the high-quality health care available at St. Rose."

While the coalition is pleased to complete the negotiations, which began last fall, it is looking for alternatives to prevent similar events in three years, Brignone said.

"There still is a considerable amount of work to do going forward to develop a new way of dealing with these issues so we don't proceed from crisis to crisis every three years," Brignone said. "We can't afford a repeat of the events. We've got to find a better way of dealing with the renewals."

In the coming weeks, coalition members will meet to discuss various options to improve access to affordable and quality health care in the Las Vegas Valley, Brignone said.

The coalition will likely consider building its own hospital and various legislative proposals including cost containment and a reinvestment act, he said.

Assembly Speaker Richard 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 money 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.

Brignone said it is too early to tell whether the coalition would support that bill or any other bill until the details are revealed.

"Nothing is off the table; everything should be explored," he said.

Some large bargaining units nationally are scaling back their hospital networks to increase savings, but the coalition has opted to have contracts with all of Southern Nevada's hospitals. Even large Las Vegas insurers do not provide access to all of the local hospitals in their networks.

"You have to balance the savings that would be achieved with the negative impact," Brignone said. " It is just as important to have accessible hospital care as affordable hospital care. We have so many members who are so diverse and live so many places in the valley. We want to give them maximum choice in scheduling and what hospitals they use."

Also, limiting the number of hospitals coalition members could access as part of their network could "put a strain" on those limited hospitals because of population growth, he said.

If the coalition opts to build its own hospital, the coalition could restrict its hospital network, Brignone said.