After Rallies and a Resolution, These Patients Will Stay in San Francisco
Families Fight Closure of Nursing Unit in San Francisco
Arbitrate or Else: Sutter Health Drives a Hard Bargain
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She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"lklivans":{"type":"authors","id":"8648","meta":{"index":"authors_1591205172","id":"8648","found":true},"name":"Laura Klivans","firstName":"Laura","lastName":"Klivans","slug":"lklivans","email":"lklivans@kqed.org","display_author_email":true,"staff_mastheads":["news","science"],"title":"Reporter and Host","bio":"Laura Klivans is a science reporter and the host of KQED's video series about tiny, amazing animals, \u003cem>Deep Look\u003c/em>. Her work can also be heard on NPR, \u003cem>Here & Now, \u003c/em>and PRI. Before working in audio, she taught, leading groups of students abroad. One of her favorite jobs was teaching on the Thai-Burmese border, working with immigrants and refugees.\r\n\r\nLaura has won three Northern California Area Emmys along with her Deep Look colleagues. She's won the North Gate Award for Excellence in Audio Reporting and the Gobind Behari Lal Award for a radio documentary about adults with imaginary friends. She's a fellowship junkie, completing the USC Center for Health Journalism's California Fellowship, UC Berkeley's Human Rights Fellowship and the Coro Fellowship in Public Affairs. Laura has a master’s in journalism from UC Berkeley and a master’s in education from Harvard.\r\n\r\nShe likes to eat chocolate for breakfast. She's also open to eating it all day long.","avatar":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g","twitter":"lauraklivans","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["editor"]},{"site":"stateofhealth","roles":["contributor","editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"Laura Klivans | KQED","description":"Reporter and Host","ogImgSrc":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lklivans"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_361004":{"type":"posts","id":"stateofhealth_361004","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361004","score":null,"sort":[1505272038000]},"guestAuthors":[],"slug":"after-rallies-and-a-resolution-these-patients-will-stay-in-san-francisco","title":"After Rallies and a Resolution, These Patients Will Stay in San Francisco","publishDate":1505272038,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After months of protests from families, city supervisors and public health officials, \u003ca href=\"http://www.cpmc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Pacific Medical Center\u003c/a> (CPMC) announced that it will continue to care for 28 patients with complex medical needs, instead of transferring them to other facilities outside the city.\u003c/p>\n\u003cp>In June, the patients and their families received letters from CPMC saying that the skilled nursing unit where they lived at St. Luke's Hospital, known as a \"subacute\" unit, was closing permanently. The hospital as a whole is closing because it doesn't meet earthquake codes, but CPMC officials are replacing it with a new building on the same site in the Mission district. But they did not plan to include any subacute beds in the new hospital, nor would they create a subacute unit in another new hospital under construction near Japantown.\u003c/p>\n\u003cp>But in an unexpected reversal, CPMC CEO \u003ca href=\"http://www.cpmc.org/about/browner_w.html\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Warren Browner\u003c/a> said Monday the hospital system will continue to care for the 28 patients who would have been affected. Spokesman Dean Fryer said the medical center changed course after hearing concerns about the potential impact of the transition on patients and their families. CPMC officials also changed their minds after facing challenges securing beds for patients elsewhere in the Bay Area.\u003c/p>\n\u003cp>Subacute nursing units treat patients with complex medical needs, such as those on ventilators, for months or even years. The patients don’t need as much care as a regular “acute” hospital patient, but do need a level of skilled nursing care that is difficult to provide at home.\u003c/p>\n\u003cp>The subacute unit at St. Luke's is the last one in San Francisco based at a hospital. Regionally and nationally, hospitals have been shuttering these units. The patients demand a high level of care, but reimbursements for the treatment -- typically through Medicaid -- are low compared to private insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Families were concerned that the move from St. Luke’s to another facility would be difficult for patients, who are in medically fragile states, and would also impose a burden on them because of the cost and difficulty of traveling farther away for visits. The San Francisco Health Commission took the issue up as well, passing a \u003ca href=\"https://www.sfdph.org/dph/files/hc/HCAgen/HCAgen2017/17_7St_Lukes_PropQ_Reso.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">resolution \u003c/a>saying the closure of this subacute unit would \"have a detrimental impact\" on health services in the city.\u003c/p>\n\u003cp>When word circulated on Monday that the patients would stay in San Francisco, family members rejoiced. Leneta Anderson’s husband has lived in St. Luke's subacute unit for 18 months. She visits him nearly every day at dinner time.\u003c/p>\n\u003cp>\"I could cry right now. I am just thrilled, thrilled that my husband and the other patients don’t have to leave,\" Anderson said over the phone on Monday. \"It’s a victory.\"\u003c/p>\n\u003cp>The new plan is for patients to move to another CPMC facility in August 2018 -- either the new Van Ness hospital, the new Mission Bernal hospital, which will replace St. Luke's, or CPMC Davies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Family members, subacute nurses, and city supervisors said Tuesday that their next goal is to increase access by advocating for the creation of more skilled nursing beds in San Francisco.\u003c/p>\n\n","blocks":[],"excerpt":"In a reversal, California Pacific Medical Center decides against shuttering specialty care unit.","status":"publish","parent":0,"modified":1505328679,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":530},"headData":{"title":"After Rallies and a Resolution, These Patients Will Stay in San Francisco | KQED","description":"In a reversal, California Pacific Medical Center decides against shuttering specialty care unit.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"After Rallies and a Resolution, These Patients Will Stay in San Francisco","datePublished":"2017-09-13T03:07:18.000Z","dateModified":"2017-09-13T18:51:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361004 https://ww2.kqed.org/stateofhealth/?p=361004","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/09/12/after-rallies-and-a-resolution-these-patients-will-stay-in-san-francisco/","disqusTitle":"After Rallies and a Resolution, These Patients Will Stay in San Francisco","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/09/KlivansSutterPatients.mp3","path":"/stateofhealth/361004/after-rallies-and-a-resolution-these-patients-will-stay-in-san-francisco","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After months of protests from families, city supervisors and public health officials, \u003ca href=\"http://www.cpmc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Pacific Medical Center\u003c/a> (CPMC) announced that it will continue to care for 28 patients with complex medical needs, instead of transferring them to other facilities outside the city.\u003c/p>\n\u003cp>In June, the patients and their families received letters from CPMC saying that the skilled nursing unit where they lived at St. Luke's Hospital, known as a \"subacute\" unit, was closing permanently. The hospital as a whole is closing because it doesn't meet earthquake codes, but CPMC officials are replacing it with a new building on the same site in the Mission district. But they did not plan to include any subacute beds in the new hospital, nor would they create a subacute unit in another new hospital under construction near Japantown.\u003c/p>\n\u003cp>But in an unexpected reversal, CPMC CEO \u003ca href=\"http://www.cpmc.org/about/browner_w.html\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Warren Browner\u003c/a> said Monday the hospital system will continue to care for the 28 patients who would have been affected. Spokesman Dean Fryer said the medical center changed course after hearing concerns about the potential impact of the transition on patients and their families. CPMC officials also changed their minds after facing challenges securing beds for patients elsewhere in the Bay Area.\u003c/p>\n\u003cp>Subacute nursing units treat patients with complex medical needs, such as those on ventilators, for months or even years. The patients don’t need as much care as a regular “acute” hospital patient, but do need a level of skilled nursing care that is difficult to provide at home.\u003c/p>\n\u003cp>The subacute unit at St. Luke's is the last one in San Francisco based at a hospital. Regionally and nationally, hospitals have been shuttering these units. The patients demand a high level of care, but reimbursements for the treatment -- typically through Medicaid -- are low compared to private insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Families were concerned that the move from St. Luke’s to another facility would be difficult for patients, who are in medically fragile states, and would also impose a burden on them because of the cost and difficulty of traveling farther away for visits. The San Francisco Health Commission took the issue up as well, passing a \u003ca href=\"https://www.sfdph.org/dph/files/hc/HCAgen/HCAgen2017/17_7St_Lukes_PropQ_Reso.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">resolution \u003c/a>saying the closure of this subacute unit would \"have a detrimental impact\" on health services in the city.\u003c/p>\n\u003cp>When word circulated on Monday that the patients would stay in San Francisco, family members rejoiced. Leneta Anderson’s husband has lived in St. Luke's subacute unit for 18 months. She visits him nearly every day at dinner time.\u003c/p>\n\u003cp>\"I could cry right now. I am just thrilled, thrilled that my husband and the other patients don’t have to leave,\" Anderson said over the phone on Monday. \"It’s a victory.\"\u003c/p>\n\u003cp>The new plan is for patients to move to another CPMC facility in August 2018 -- either the new Van Ness hospital, the new Mission Bernal hospital, which will replace St. Luke's, or CPMC Davies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Family members, subacute nurses, and city supervisors said Tuesday that their next goal is to increase access by advocating for the creation of more skilled nursing beds in San Francisco.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361004/after-rallies-and-a-resolution-these-patients-will-stay-in-san-francisco","authors":["8648"],"categories":["stateofhealth_11","stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_3164","stateofhealth_2808","stateofhealth_2519","stateofhealth_3160","stateofhealth_2859"],"featImg":"stateofhealth_361016","label":"stateofhealth"},"stateofhealth_360952":{"type":"posts","id":"stateofhealth_360952","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360952","score":null,"sort":[1504824905000]},"guestAuthors":[],"slug":"families-fight-closure-of-nursing-unit-in-san-francisco","title":"Families Fight Closure of Nursing Unit in San Francisco","publishDate":1504824905,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Every evening, San Francisco resident Leneta Anderson takes the 44-O'Shaughnessy bus from her home in Silver Terrace, near the Bayview, to \u003ca href=\"http://www.cpmc.org/about/stluke.html\" target=\"_blank\" rel=\"noopener noreferrer\">St. Luke’s Hospital\u003c/a> in the Mission. She eats dinner there with her husband of 59 years, Richard. He’s been living there for the past year and a half, in a skilled nursing unit that offers \"sub-acute\" care.\u003c/p>\n\u003cp>Sub-acute nursing units treat patients with complex medical needs, such as tracheostomies, sometimes for months or even years. The patients don't need as much care as a regular \"acute\" hospital patient, but do need a level of skilled nursing care that is difficult to provide at home. Richard, for example, has congestive heart failure and diabetes. The 83-year-old also depends on a ventilator and needs dialysis three times a week.\u003c/p>\n\u003cp>St. Luke's is the last hospital in San Francisco with a sub-acute unit, and parent company Sutter Health has plans to close it by the end of the year.\u003c/p>\n\u003cp>Anderson is worried that Richard will be transferred somewhere far away.\u003c/p>\n\u003cp>\"I don’t want Richard to have to be transported to Los Angeles, San Jose, Sacramento,\" she said. \"I need him in San Francisco where I can see him.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Anderson spoke at a press conference Tuesday on the steps of City Hall. She was joined by other family members opposed to the closure of the sub-acute unit.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cpmc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Pacific Medical Center (CPMC)\u003c/a>, a Sutter Health affiliate, operates St. Luke’s Hospital. To comply with earthquake building codes, CPMC is demolishing the old hospital, but the replacement building will not include a sub-acute unit. CPMC originally said residents would be transferred by Oct. 31, but more recently stated the process could go on until the end of the year.\u003c/p>\n\u003cp>Many of the 24 patients in the unit at St. Luke's have been there for years. Many depend on Medi-Cal for coverage, which reimburses hospitals at a lower rate than private insurance or Medicare. Opponents of the closure have speculated that CPMC is closing the sub-acute unit because of the lower reimbursements, but a spokeswoman for Sutter denied that finances were part of the decision.\u003c/p>\n\u003cp>Families are concerned that the move from St. Luke's to another facility will be difficult for patients, who are in medically fragile states, and for themselves, because of the cost and difficulty of traveling farther for visits.\u003c/p>\n\u003cp>If Richard were transferred out of the city, he would get fewer visits from family members, Leneta Anderson said: \"It will kill him if he doesn't see my face or my children.\"\u003c/p>\n\u003cfigure id=\"attachment_360956\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-360956\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-800x600.jpg\" alt=\"Leneta Anderson holds photos of her husband Richard, who is a patient in the sub-acute skilled nursing facility at St. Luke's Hospital.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Leneta Anderson holds photos of her husband Richard, who is a patient in the sub-acute skilled nursing facility at St. Luke's Hospital. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sutter is also building a new hospital on Cathedral Hill at Van Ness Avenue and Geary Street. Representatives have said neither Cathedral Hill's hospital or the new one being built on the St. Luke's Campus will have enough space for a sub-acute unit and that they'll put together appropriate transfer plans for each affected patient and their families. But Anderson said all she's received so far is a list of hospitals where Richard might end up, and she hasn't found it helpful.\u003c/p>\n\u003cp>\"We want to stay where we are,\" Anderson said, meaning she wants Richard to continue as a patient in the new hospital that will be built alongside the old building, on Cesar Chavez Street. Other relatives agree.\u003c/p>\n\u003cp>While the city can't stop the closure of the sub-acute unit at St. Luke's, San Francisco Supervisors \u003ca href=\"http://sfbos.org/supervisor-safai-district-11\" target=\"_blank\" rel=\"noopener noreferrer\">Ahsha Safaí\u003c/a> and \u003ca href=\"http://sfbos.org/supervisor-ronen-district-9\" target=\"_blank\" rel=\"noopener noreferrer\">Hillary Ronen\u003c/a> are putting pressure on Sutter to reconsider.\u003c/p>\n\u003cp>\"It's unfathomable, unconscionable, and essentially inhumane,\" Safai said. He believes moving patients out of San Francisco County would be hard on their families. \"You're talking about -- quite often -- people that essentially rely on public transportation. They would literally have no way to get to see their family member in the hospital if they were shipped out of the county.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.sfdph.org/dph/comupg/aboutdph/hc/\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco's Health Commission\u003c/a>, the governing body of the city's Department of Public Health, also issued a resolution condemning the closure of the sub-acute unit. In it, the commission says the closure would have a \"detrimental impact on the health care services in the community.\"\u003c/p>\n\u003cp>CPMC CEO Dr. Warren Browner issued a statement saying that the health system has identified sub-acute beds in Alameda and Daly City and will work to secure those for the patients currently in St. Luke's.\u003c/p>\n\u003cp>Dean Fryer, a spokesman for CPMC, said hospital administrators have been discussing the closure of the sub-acute unit with the city since 2011. But families of the patients say they didn't get notified by letter until June.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The issue will be taken up next during the Board of Supervisors meeting on Sept. 12.\u003c/p>\n\n","blocks":[],"excerpt":"As St. Luke's gets ready to replace an old hospital, the fate of two dozen patients has rekindled a fight over what a health provider owes the city. ","status":"publish","parent":0,"modified":1505284205,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":844},"headData":{"title":"Families Fight Closure of Nursing Unit in San Francisco | KQED","description":"As St. Luke's gets ready to replace an old hospital, the fate of two dozen patients has rekindled a fight over what a health provider owes the city. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Families Fight Closure of Nursing Unit in San Francisco","datePublished":"2017-09-07T22:55:05.000Z","dateModified":"2017-09-13T06:30:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360952 https://ww2.kqed.org/stateofhealth/?p=360952","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/09/07/families-fight-closure-of-nursing-unit-in-san-francisco/","disqusTitle":"Families Fight Closure of Nursing Unit in San Francisco","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/09/KlivansStLukes.mp3","path":"/stateofhealth/360952/families-fight-closure-of-nursing-unit-in-san-francisco","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every evening, San Francisco resident Leneta Anderson takes the 44-O'Shaughnessy bus from her home in Silver Terrace, near the Bayview, to \u003ca href=\"http://www.cpmc.org/about/stluke.html\" target=\"_blank\" rel=\"noopener noreferrer\">St. Luke’s Hospital\u003c/a> in the Mission. She eats dinner there with her husband of 59 years, Richard. He’s been living there for the past year and a half, in a skilled nursing unit that offers \"sub-acute\" care.\u003c/p>\n\u003cp>Sub-acute nursing units treat patients with complex medical needs, such as tracheostomies, sometimes for months or even years. The patients don't need as much care as a regular \"acute\" hospital patient, but do need a level of skilled nursing care that is difficult to provide at home. Richard, for example, has congestive heart failure and diabetes. The 83-year-old also depends on a ventilator and needs dialysis three times a week.\u003c/p>\n\u003cp>St. Luke's is the last hospital in San Francisco with a sub-acute unit, and parent company Sutter Health has plans to close it by the end of the year.\u003c/p>\n\u003cp>Anderson is worried that Richard will be transferred somewhere far away.\u003c/p>\n\u003cp>\"I don’t want Richard to have to be transported to Los Angeles, San Jose, Sacramento,\" she said. \"I need him in San Francisco where I can see him.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Anderson spoke at a press conference Tuesday on the steps of City Hall. She was joined by other family members opposed to the closure of the sub-acute unit.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cpmc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Pacific Medical Center (CPMC)\u003c/a>, a Sutter Health affiliate, operates St. Luke’s Hospital. To comply with earthquake building codes, CPMC is demolishing the old hospital, but the replacement building will not include a sub-acute unit. CPMC originally said residents would be transferred by Oct. 31, but more recently stated the process could go on until the end of the year.\u003c/p>\n\u003cp>Many of the 24 patients in the unit at St. Luke's have been there for years. Many depend on Medi-Cal for coverage, which reimburses hospitals at a lower rate than private insurance or Medicare. Opponents of the closure have speculated that CPMC is closing the sub-acute unit because of the lower reimbursements, but a spokeswoman for Sutter denied that finances were part of the decision.\u003c/p>\n\u003cp>Families are concerned that the move from St. Luke's to another facility will be difficult for patients, who are in medically fragile states, and for themselves, because of the cost and difficulty of traveling farther for visits.\u003c/p>\n\u003cp>If Richard were transferred out of the city, he would get fewer visits from family members, Leneta Anderson said: \"It will kill him if he doesn't see my face or my children.\"\u003c/p>\n\u003cfigure id=\"attachment_360956\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-360956\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-800x600.jpg\" alt=\"Leneta Anderson holds photos of her husband Richard, who is a patient in the sub-acute skilled nursing facility at St. Luke's Hospital.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/09/RS26488_St-Lukes-Rally2-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Leneta Anderson holds photos of her husband Richard, who is a patient in the sub-acute skilled nursing facility at St. Luke's Hospital. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sutter is also building a new hospital on Cathedral Hill at Van Ness Avenue and Geary Street. Representatives have said neither Cathedral Hill's hospital or the new one being built on the St. Luke's Campus will have enough space for a sub-acute unit and that they'll put together appropriate transfer plans for each affected patient and their families. But Anderson said all she's received so far is a list of hospitals where Richard might end up, and she hasn't found it helpful.\u003c/p>\n\u003cp>\"We want to stay where we are,\" Anderson said, meaning she wants Richard to continue as a patient in the new hospital that will be built alongside the old building, on Cesar Chavez Street. Other relatives agree.\u003c/p>\n\u003cp>While the city can't stop the closure of the sub-acute unit at St. Luke's, San Francisco Supervisors \u003ca href=\"http://sfbos.org/supervisor-safai-district-11\" target=\"_blank\" rel=\"noopener noreferrer\">Ahsha Safaí\u003c/a> and \u003ca href=\"http://sfbos.org/supervisor-ronen-district-9\" target=\"_blank\" rel=\"noopener noreferrer\">Hillary Ronen\u003c/a> are putting pressure on Sutter to reconsider.\u003c/p>\n\u003cp>\"It's unfathomable, unconscionable, and essentially inhumane,\" Safai said. He believes moving patients out of San Francisco County would be hard on their families. \"You're talking about -- quite often -- people that essentially rely on public transportation. They would literally have no way to get to see their family member in the hospital if they were shipped out of the county.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.sfdph.org/dph/comupg/aboutdph/hc/\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco's Health Commission\u003c/a>, the governing body of the city's Department of Public Health, also issued a resolution condemning the closure of the sub-acute unit. In it, the commission says the closure would have a \"detrimental impact on the health care services in the community.\"\u003c/p>\n\u003cp>CPMC CEO Dr. Warren Browner issued a statement saying that the health system has identified sub-acute beds in Alameda and Daly City and will work to secure those for the patients currently in St. Luke's.\u003c/p>\n\u003cp>Dean Fryer, a spokesman for CPMC, said hospital administrators have been discussing the closure of the sub-acute unit with the city since 2011. But families of the patients say they didn't get notified by letter until June.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The issue will be taken up next during the Board of Supervisors meeting on Sept. 12.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360952/families-fight-closure-of-nursing-unit-in-san-francisco","authors":["8648"],"categories":["stateofhealth_11","stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_3163","stateofhealth_2808","stateofhealth_2519","stateofhealth_3162","stateofhealth_3160","stateofhealth_3161","stateofhealth_2859"],"featImg":"stateofhealth_360953","label":"stateofhealth"},"stateofhealth_225405":{"type":"posts","id":"stateofhealth_225405","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"225405","score":null,"sort":[1471320114000]},"guestAuthors":[],"slug":"arbitrate-or-else-sutter-health-drives-a-hard-bargain","title":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","publishDate":1471320114,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>[contextly_sidebar id=\"71H0Ojb2GH2PmTeKnFMAoSO20SXx8Yvn\"]“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Sutter’s Gleeson says if companies don’t sign the letter, Sutter will ask health insurers to find another way to convince companies to agree to the arbitration terms.\u003c/p>\n\n","blocks":[],"excerpt":"Some companies are balking at health giant's move to have disputes argued behind closed doors.","status":"publish","parent":0,"modified":1471385604,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1212},"headData":{"title":"Arbitrate or Else: Sutter Health Drives a Hard Bargain | KQED","description":"Some companies are balking at health giant's move to have disputes argued behind closed doors.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","datePublished":"2016-08-16T04:01:54.000Z","dateModified":"2016-08-16T22:13:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"225405 http://ww2.kqed.org/stateofhealth/?p=225405","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/08/15/arbitrate-or-else-sutter-health-drives-a-hard-bargain/","disqusTitle":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","path":"/stateofhealth/225405/arbitrate-or-else-sutter-health-drives-a-hard-bargain","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sutter’s Gleeson says if companies don’t sign the letter, Sutter will ask health insurers to find another way to convince companies to agree to the arbitration terms.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/225405/arbitrate-or-else-sutter-health-drives-a-hard-bargain","authors":["3205"],"categories":["stateofhealth_2442"],"tags":["stateofhealth_2808","stateofhealth_482","stateofhealth_2519","stateofhealth_2859"],"featImg":"stateofhealth_225429","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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