Contracting Was Healthy Move for Nearby County

Not all counties operate their own public hospital system. In fact, critics of the Ventura County Medical Center often say that it should follow Santa Barbara County’s example and contract out for health-care services.

For years, the neighboring county ran two public hospitals, one in the city of Santa Barbara and the other in Santa Maria.

Operating in the red, with old equipment and even older facilities--parts of the former Santa Barbara hospital were constructed in 1911--the county decided to close its two hospitals in the late 1970s.

Since then, the county has contracted with Cottage Hospital and Marian Medical Center--both private, nonprofit facilities--to provide medical services for indigent patients.

“For our county, closing down the two hospitals has been a good decision,” said Roger Heroux, assistant director of Santa Barbara County Health Care Services. “It’s more efficient.”

But is it? Ventura County officials say not necessarily.

In addition to contracting with two hospitals, Santa Barbara County itself operates six outpatient clinics. Those clinics combined handle about 127,000 patient visits a year, officials said.

To offset its costs, Santa Barbara County subsidizes its health-care budget with $3.8 million annually from its general fund, said Steven Escoboza, director of Health Care Services.

In comparison, Ventura County spent an identical $3.8 million last year to operate its own public hospital in addition to seven outpatient clinics.

Last year, those clinics alone handled 300,000 patient visits, more than twice as many as the Santa Barbara County clinics.

“They are spending as much as we do, and we have a higher number of visits,” said Pierre Durand, director of the Ventura County Health Care Agency. “That shows that our system is much more cost-effective.”

Still, both Durand and Escoboza said it is unfair to compare the two systems. They said each is organized and funded differently.

For instance, Ventura County contracts with private physicians to run it’s county satellite clinics, which saves money for both.

Santa Barbara County, on the other hand, operates its own outpatient clinics and employs the doctors that work in them, resulting in increased costs.

But Escoboza said his county is exploring the possibility of either contracting out for clinic services or setting up a similar public-private partnership as Ventura County.