Sutter Health, one of the largest health care providers in Sonoma County and California, has filed a request with the state to market its own health plan in Sonoma County possibly beginning next year, a move that locally would allow Sutter to develop a more integrated managed care model like that offered by Kaiser Permanente.
The step, if approved, could bring a more affordable health plan option to patients using the local Sutter Health system, according to insurance experts. It could also spur greater competition for patients between Sutter and the area’s two other dominant health care providers, Kaiser Permanente and St. Joseph Health, which operates Santa Rosa Memorial Hospital.
Monica Majors, a vice president of strategic sales and marketing for the new insurance plan, called Sutter Health Plus, said it would allow Sutter to see patients through the “full spectrum” of their medical needs, much like the HMO-model that Kaiser offers under its own exclusive health plan.
“Having our own health plan allows us to see the full patient picture,” Majors said.
Unlike Kaiser, which is generally closed to other insurance providers, Sutter-affiliated physicians would continue to accept other health plans such at Blue Shield and Health Net alongside its own.
Sutter Health Plus is already offered in an eight-county region taking in much of the Central Valley. Sutter’s request to the state is to add Sonoma County to that region, extending from Sutter County to the north; parts of Placer and El Dorado counties to the east; Stanislaus County to the south; and Solano and Yolo counties to the west.
The proposal is currently under review with the state Department of Managed Health Care, which regulates California health plans. Sutter filed a “notice of material modification” with the agency on Oct. 6 to advance its proposal.
The move, underway for some time, comes less than a month after Sutter opened its new $292 million hospital and 80,000-square-foot medical office building off Mark West Springs Road north of Santa Rosa. The new hospital, set to host or employ 950 doctors, nurses and other staff, is expected to receive about 50,000 hospital visitors annually.
Sutter patients greeted news of the potential new health plan with a wait-and-see outlook Monday, signaling that any new contender would have to offer them competitive benefits and rates to make them switch.
“I’d have to see the plan and compare it to my current plan,” said Lisa Steinkamp, who was taking her 4-year-old son Booker to his Sutter-affiliated pediatrician, Dr. Fred Brewer, for a wellness check and flu vaccination. Steinkamp said her family currently has a Health Net plan.
Santa Rosa health insurance broker David Hodges said Sutter’s new plan, if priced right, could offer a more affordable option for local residents who currently receive their medical care through Sutter-affiliated physicians. Such patients could switch from Blue Shield or Blue Cross to the new Sutter plan, he said.
“I’m thrilled that Sutter is coming out with its own plan,” Hodges said. “If it comes out with rates that are affordable, it will be a powerful, powerful plan.”
Majors, the Sutter health plan vice president, said that if approved the new plan offered in Sonoma County will be essentially the same as what is currently offered in the Central Valley.
Majors said the plan received state approval in April 2013 and began enrolling members in January 2014. Pending state approval, Majors said she hopes to begin marketing the plan in Sonoma County by early next year.