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Press release Health Care Access For The Chinese Community Threatened By Major Medical Group! April 5, 2006, San Francisco, CA Board of Supervisors to Consider Resolution directed at health care giant Brown and Toland Medical Group, that they say are potentially destructive to their community's health care system. One of the largest medical groups in Northern California, Brown & Toland Medical Group (BTMG) has threatened access to health care in the San Francisco Chinese community by trying to coerce physicians to leave the Chinese Hospital affiliated medical group, Chinese Community Health Care Association (CCHCA). The Chinese Hospital was founded over 100 years ago because the Chinese Community was not allowed to seek medical care from any of the established health or hospital entities in San Francisco. On April 4, Board President Aaron Peskin, introduced a resolution condemning Brown & Toland's current program of inducing Chinese Community physicians to resign from CCHCA and become exclusive members of Brown & Toland. The resolution, which the Board will consider at its hearing next Tuesday, April 11, finds that the threatened resignations of the CCHCA doctors are anticompetitive, will significantly weaken the Chinese Hospital and Chinese integrated health system, and are contrary to the public good and urges Brown and Toland to cease its efforts to require its currently non-exclusive affiliated doctors to resign from other physician organizations such as CCHCA. A copy of the resolution submitted by Board President Peskin for action is attached. Supervisor Aaron Peskin states "Brown and Toland's anti-competitive tactics are threatening the viability of one of San Francisco's most cherished health care providers. I am committed to making Brown and Toland cease and desist their predatory practices." Health Care Access For The Chinese Community Threatened By Major Medical Group! “It is ironic that some 100 years later, an organization is trying to again limit access to care for the Chinese Community and to cause hardship to the last single stand alone Hospital in San Francisco and the only Chinese Hospital in the Nation.” said James K. Ho, President, Board of Trustees, Chinese Hospital Association. Members of the Chinese Hospital Board of Trustees and other community leaders expressed their concerns at a community forum conducted on March 27, 2006, at Chinese Hospital. The community has taken their concerns to the City Attorney, the San Francisco Board of Supervisors and the Federal Trade Commission, which is monitoring Brown and Toland's compliance with a consent decree that was entered after the FTC had sued Brown and Toland based on allegations that Brown and Toland had conspired to fix and raise prices for physician services in San Francisco. Dr. Eric Leung, President of CCHCA stated, "When Brown & Toland tried to induce our doctors to resign we attempted to resolve the problem by asking Brown & Toland to sign a simple promise that they would 'not discriminate' anytime in the future against any doctor based on his or her affiliation with the Chinese integrated health system. Brown & Toland refused to sign the non-discrimination statement." Brown and Toland Medical Group has more than 1500 physicians, while CCHCA has 160 bilingual bicultural physicians. BTMG has offered several financial incentives, including signing bonuses for physicians to resign CCHCA. CCHCA has no exclusivity requirements for participation in their medical group, which serves more than 27,000 mostly lower income, Chinese-speaking patients through several insurance plans. Approximately 20,000 of these patients have insurance though the Chinese Community Health Plan and the San Francisco Health Plan, which covers Medi-Cal and low income uninsured children and families. Physicians that resign, would have to withdraw their services from these two insurance plans since BTMG does not contract with the two plans. This deprives the community of the availability of many of their most popular bilingual physicians. When CCHCA agreed to talk with BTMG to see how physicians could continue to serve the Chinese community while participating in BTMG, it was a surprise that BTMG continued to coerce CCHCA physicians to resign from CCHCA during these conversations. Attorneys for Chinese Hospital, Chinese Community Health Plan and Chinese Community Health Care Association have advised that because BTMG holds a dominant position in the San Francisco Health Care market, they (BTMG) cannot legally insist on or obtain exclusive membership arrangements with Doctors. Health Care Access For The Chinese Community Threatened By Major Medical Group! These actions on behalf of BTMG have immediate effect on the health care of the Chinese community but also a major detrimental effect on the whole health care system which cares for the entire San Francisco Chinese population. Chinese Hospital Association, Chinese Community Health Care Association and Chinese Community Health Plan form the Chinese Hospital Integrated Delivery System, which exists to deliver quality health care in a cost-effective manner, is responsive to the community's ethnic and cultural uniqueness and, is accessible to all socioeconomic levels. For more information or to schedule an interview with Brenda Yee CEO, Chinese Hospital, Richard Loos, CEO of Chinese Community Health Plan, or Dr. SW Chan, Board member of Chinese Community Health Care Association and Chinese Community Health Plan, please contact: Duane Oshinomi, Director of CHIDS at 415- 677-2493. -xxxx- Resolution urging Brown and Toland to cease requiring exclusivity of physicians to participate in the Brown and Toland Preferred Network, in violation of the policy of the City and County of San Francisco and the state and federal and which is affecting the well being of the Chinese Community in San Francisco. WHEREAS, Chinese Hospital is a unique, nonprofit acute-care healthcare provider within the City and County of San Francisco, with a long and rich history of providing access to culturally competent health care services for the Chinese Community for over 100 years, and is the last independent private hospital in San Francisco; and, WHEREAS, Chinese Hospital provides the highest percentage of care to Medicare and Medi-Cal eligible San Francisco residents of any hospital in the City other than San Francisco General Hospital (92% share of total hospital patient days in 2005); and, WHEREAS, Chinese Community Health Care Association (CCHCA) is a nonprofit,mutual benefit association of over 165 physicians which has served the Chinese community for over twenty years; and, WHEREAS, Chinese Community Health Plan (CCHP) is a wholly-owned subsidiary of Chinese Hospital, was established over twenty years ago to provide a culturally sensitive and affordable health insurance option to small community employers and individuals who are generally not served by the broader health insurance marketplace; and, WHEREAS, Chinese Community Health Plan supported the Hotel Employees and Restaurant Employees Union Local 2 by extending health coverage to Local 2 employees during their lock-out by large hotel employers during December 2004 and January 2005, to assure that hotel workers and their families covered by CCHP did not face a health care crisis during this difficult period and was made without regard to the outcome of the trust fund negotiations; and, WHEREAS, The Chinese Hospital and CCHCA together serve San Francisco Health Plan (SFHP), the county Medicaid health plan, as the second largest non-county group provider serving over 7000 Medicaid, Healthy Families, and Healthy Kids members in the County; and, WHEREAS, These three entities (Chinese Hospital, CCHCA, and CCHP) serve as an integrated delivery system (Chinese Integrated Health System) by providing health plan products and services to meet the special cultural needs of the Chinese American community in San Francisco, and providing these services at the lowest price in the local marketplace; and, WHEREAS, The Chinese Integrated Health System delivers care to over 27,000 enrolled members, the majority of whom are senior citizens, monolingual, indigent, and/or surviving at a significantly lower socioeconomic status; and, WHEREAS, Brown and Toland Medical Group (BTMG) is attempting to enroll over 50% of CCHCA physicians into their exclusive preferred network and thereby force their resignation from CCHCA thus seriously impeding the ability of the network from meeting the health care needs of members; and, WHEREAS, The loss of a significant number of physicians from CCHCA would also seriously impede the ability of the CCHP to provide health care service to all plan members, including one of the largest Medicare Advantage programs in San Francisco many of whom are dual eligible (Medicare / Medicaid) members, and thereby may place its HMO license in jeopardy; and, WHEREAS, The actions of BTMG, which threaten a loss of most of the CCHCA physicians and the potential inability of CCHP to continue to operate, would deprive the community of affordable, culturally competent care, and add to the burden of the County of San Francisco to care for these safety net patients; and, WHEREAS, BTMG is demanding exclusivity which would prevent Chinese community physicians from participating in the Chinese Community Health Care Association (CCHCA), an independent physicians association (IPA) medical group that has been in existence since 1982; and, WHEREAS, BTMG is by far the dominant independent physicians practice association in San Francisco, with approximately 1,500 affiliated physicians; and, WHEREAS, BTMG controls healthcare for approximately 190,000 HMO patient lives in the San Francisco market, with an additional 30,000-40,000 preferred provider organization (PPO) patients; and, WHEREAS, BTMG thus controls close to 80 percent of the non-Kaiser managed care market in San Francisco, whether measured by doctors or patients; and, WHEREAS, the only other IPAs competing in the San Francisco Market area CCHCA, Hill Physicians, and Physicians Independent Medical Group ("PIMG"), none of which have more than 200 affiliated physicians; and, WHEREAS, BTMG's current market dominance requires that CCHCA doctors (and also doctors affiliated with either Hill Physicians or PIMG) also must affiliate with BTMG in order to maintain strong, fully enrolled, practices, and accordingly, approximately 140 of the CCHCA-affiliated doctors are also affiliated with BTMG; and, WHEREAS, BTMG is the result of the 1997 merger of 410 UCSF physicians with the physicians formerly affiliated with California Pacific Medical Center, which upon merger established the largest IPA in San Francisco, with control of the City's HMO physician services market; and, WHEREAS, promptly after its creation through merger in 1997, BTMG continued to aggressively recruit additional physicians from competing IPA's, including during 1998-1999, the aggressive recruitment of physicians affiliated with St. Luke's Hospital to BTMG, and requiring those recruited doctors to admit their patients needing hospital services exclusively to either UCSF or CMPC, to the great financial injury of St. Luke's Hospital; and, WHEREAS, The United States Federal Trade Commission determined, following an investigation conducted in 2001-2003, that BTMG was using its monopoly position to conspire with many of its is affiliated physicians to fix prices charged to the non-Kaiser health plans for physician services; and, WHEREAS, The United States Federal Trade Commission sued BTMG in 2003 for unlawfully fixing and increasing prices charged to the non-Kaiser health plans for physician services, including for PPO physician services; and, WHEREAS, BTMG entered a consent decree in 2004, under which it was forbidden from negotiating or fixing PPO pricing on behalf of or for any physicians, but is again attempting to further increase its monopoly position; and, WHEREAS, Previously BTMG has allowed non-exclusive affiliations for its member physicians, as this was necessary to maintain a competitive market for physician services; and, WHEREAS, BTMG has recently changed its position, and is now actively pressuring many CCHCA physicians, currently also affiliated with BTMG on a non-exclusive basis to sign agreements that call for an exclusive relationship with BTMG, and consequently, would force their resignation from CCHCA and the Chinese Hospital network; and, WHEREAS, BTMG has offered these targeted physicians significant monetary and other inducements to resign from CCHCA so as to become exclusively affiliated with BTMG; these "inducements" include not only large signing bonuses, but also the threat that physicians who do not "go along" will receive substantially less compensation and will be discriminated against in other ways; and, WHEREAS, The clear effect of BTMG targeted solicitation of many of CCHCA’s key specialists and primary care physician members, is to obtain their resignation from CCHCA, and to move the patients loyal to those physicians out of the Chinese Hospital system, thus depriving patients of the most culturally appropriate care; and, WHEREAS, Because many patients tend to be loyal to their primary care physicians they trust, as well as to the specialists whose care they need, it could therefore be expected that such patients currently enrolled with the targeted CCHCA doctors may, following their doctor's resignation from CCHCA, move from Chinese Community Health Plan and enroll themselves (and their family members) into other health plans with which BTMG contracts; and, WHEREAS, BTMG's current physician exclusivity solicitation program threatens similar injury to the two other remaining IPAs in San Francisco and to the hospitals with which they are affiliated; and, WHEREAS, As BTMG further increases its market power by demanding exclusive affiliation of key physicians in the San Francisco market, it will become even more difficult for other medical practice associations, or independent physician practices, to be formed, grow or compete; and, WHEREAS, The exclusive provider agreements BTMG is inducing San Francisco doctors to enter into threatens an unreasonable restraint of critical physician and hospital services in San Francisco and further threatens grave injury to the Chinese Community and general public of all the people of San Francisco; now, therefore, be it RESOLVED, That the Board of Supervisors of the City and County of San Francisco find it contrary to the public welfare and policy of this city and county for any physicians' independent practice association (IPA) to require or condition affiliation or membership on the affiliated doctor resigning from or agreeing not to join, any other IPA serving this city and county; and be it, FURTHER RESOLVED, That the Board of Supervisors of the City and County of San Francisco support the Chinese community in San Francisco in stopping Brown and Toland from requiring exclusivity of physicians to participate in the Brown and Toland Preferred Network; and, be it, FURTHER RESOLVED, That the Board of Supervisors supports a City Attorney investigation of Brown and Toland regarding their requirement of exclusivity of physicians to participate in the Brown and Toland Preferred Network that could bring harm to the health of the people of San Francisco. |
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© 2002- Chinese Hospital. All Rights Reserved.
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