Hospital overcrowding and healthcare access challenges have prompted two counties in Central California to issue emergency declarations in less than a week. Meanwhile, the largest health system in the region has gone out of network with several commercial insurance plans.
The emergency declarations over healthcare access largely stem from the recent closure of Madera (Calif.) Community Hospital, the city's only hospital for about 66,000 residents. It officially shut its doors at midnight on Dec. 30, after Trinity Health's plan to buy the hospital fell through because the health system didn't accept the conditions set forth by California Attorney General Rob Bonta, The Fresno Bee reported Jan. 3. The Madera County Sheriff's Office declared a local state of emergency on Dec. 29, citing the "significant impact" the closure will have on the community.
"The lack of hospital services in Madera County is expected to strain local resources deployed within Madera County, thereby depleting ambulance and response resources such as law enforcement and fire," the sheriff's office wrote in a Facebook post. "By proclaiming a local state of emergency we are formally requesting help from state and federal officials."
The closure means residents in Madera will have to travel at least a half hour to other hospitals, many of which are in neighboring Fresno County and already overcrowded, Madera County officials said during their Dec. 29 meeting.
In response, Fresno County proclaimed its own emergency declaration on Jan. 3, citing the additional strain the Madera hospital's closure has put on other area hospitals amid a surge in respiratory viruses. The Fresno County Board of Supervisors also said local emergency services were operating under an "assess and refer" policy, which diverts non-emergency patients from hospitals to other sources of care, and that it adopted the emergency resolution to emphasize the need for assistance at the state and federal level, according to the Fresno Bee.
Fresno County's largest health system, Clovis, Calif.-based Community Health System, operates four hospitals, a cancer institute and other outpatient facilities in the area.
On Dec. 31, in-network contracts expired between Community and several commercial payers, including UnitedHealthcare, Cigna and Anthem Blue Cross. A system spokesperson told Becker's Jan. 4 the involved parties are still actively negotiating to reach agreements.
"As Community negotiates in good faith we must ask commercial health plans to acknowledge the unprecedented cost challenges of delivering care to the residents of the Central Valley and join us in reaching a fair and reasonable agreement," the system wrote on its website.
A spokesperson for UnitedHealthcare told The Fresno Bee Dec. 19 that the system asked for an "egregious and unreasonable" rate increase.
"This is not affordable or sustainable," the spokesperson said. "We've offered [Community Health System] market-competitive rate increases that will ensure its hospitals and facilities continue to be fairly compensated for the care they provide to our members."
The affected facilities include Community Regional Medical Center, Fresno Heart & Surgical Hospital, Community Behavioral Health Center, Community Subacute & Transitional Care Center, Community Home Health and Community Health Partners, and Clovis Community Medical Center.
On Jan. 2, Centene's Health Net and Community signed an in-network agreement covering commercial, Medicare and Medi-Cal plans.