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Health care experts see more choice, competition for Sonoma County patients

It was not that long ago that health care in Sonoma County was a troubled landscape.

In the aftermath of the 2001 collapse of Health Plan of the Redwoods, the county's largest HMO, many local hospitals and doctors battled each other for insured patients who had not yet been swallowed by fast-growing Kaiser Permanente.

Shrinking government reimbursements were forcing doctors to abandon their private practices and sign up for an employee's paycheck from Kaiser or Sutter Health. District hospitals searched for a lifeline that could help them stay afloat.

To be sure, many of these problems still exist, but health care experts say a new era is about to begin — one of greater competition among the local health care giants and more choices for individuals.

Two weeks ago, a Sacramento-based HMO known as Western Health Advantage announced that was entering the North Bay market by partnering with a regional network of hospitals and physicians in Sonoma, Napa and Marin counties. The insurance plan is expected to compete head-to-head with Kaiser on cost and quality when it begins selling coverage plans in the North Bay next year.

At the same time, Sutter Health, which runs Sutter Medical Center of Santa Rosa, announced that it had filed for a state license that would allow it to sell its own health plan.

These moves — most immediately the arrival of Western Health Advantage — take place on the eve of full implementation of President Barack Obama's health care overhaul.

While the verdict is still out on whether Obama's Patient Protection and Affordable Care Act will solve the country's health care crisis, the medical industry is nevertheless gearing up for major changes in 2014. These include launching health insurance exchanges, the expansion of Medicaid, individual and employer mandates and the prohibition of insurance discrimination based on pre-existing conditions.

Dr. Walt Mills, a Kaiser family practice doctor and the new president of the Sonoma County Medical Association, said the president's health care overhaul and health care economics are combining to drive the system toward a more vertically integrated and patient-centered model. That means both medical providers and health plans are increasingly expected to produce results: healthier patients.

"If somebody ends up in the emergency room because they didn't have access to high-quality primary care in a medical home, that's of no value" to the local community, Mills said.


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