RIDEOUT: Provider

for terminating the contract several months ago was simply because the reimbursement model California Health and Wellness was using didn’t come close to helping the organization cover the costs of providing care to those patients.

“It means that the reimbursement for services that has been proposed to us by California Health and Wellness does not cover the cost the organization incurs in caring for those patients,” Patrizio said. “In other words we lose money in every interaction under that contract.”

California Health and Wellness provides insurance to Medi-Cal recipients who elect to go through the company. Those insured through the company can still access Rideout Health’s emergency room services, however, they will be financially responsible for their care.

California Health and Wellness sent a letter out to its customers living in the area that their contract with Rideout Health had been terminated as of March 17.

While the two entities are not under contract with each other, those insured through California Health and Wellness will have to access services and clinics through hospitals elsewhere.

In the letter, the company recommended using Orchard Hospital (Gridley), Oroville Hospital, Sierra Nevada Memorial Hospital (Grass Valley) and Mercy San Juan Medical Center (Carmichael).

“We continue negotiating with Rideout Health, and we hope we are able to come to a mutually-agreeable contract that preserves our members’ access to affordable health care,” said Brad Kieffer, spokesperson for California Health and Wellness.

Patrizio said Rideout Health has recently renewed contracts with other MediCal providers and was able to reach mutually agreeable terms.

“We continue to work with California Health and Wellness in hopes of reaching a new agreement with them,” Patrizio said. “In the meantime, there are other alternatives for community residents who utilize Medi-Cal.”

Patrizio said those insured through California Health and Wellness have the option to shift their coverage to another Medi-Cal insurance provider.

Information on available providers can be found on the state’s Department of Managed Health Care website (www.dmhc.ca.gov), he said.

“We’d be very happy to reach a new agreement with California Health and Wellness, but it must be mutually agreeable, and from Rideout’s perspective, it must not impact the sustainability of our mission as an organization,” Patrizio said.

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