Hospital Will End Its Contract With Kaiser Health Plan

A Mission Viejo hospital said Monday it will not renew its contract with Kaiser Permanente to provide emergency room and maternity care for some 50,000 members of the state’s largest health maintenance organization.

Mission Hospital Regional Medical Center, which gets 10% of its patients through Kaiser, said it no longer can afford to provide care at the prices Kaiser is willing to pay. The current contract expires at the end of the year.

Kaiser officials said the HMO is negotiating with other area hospitals to provide care starting in January.

“We’re in south Orange County to stay,” Kaiser spokesman Jim Anderson said. “We are confident we will have an agreement in place before the end of the year to serve those members who live there.”

The HMO, with about 50,000 members living in the county south of Irvine, has an urgent-care facility in Mission Viejo to handle minor emergencies and after-hours medical needs. It also is constructing a building in San Juan Capistrano to house doctors’ offices.

Mission Hospital’s decision not to renew the contract came after a year of financial negotiations.

“We’ve been accepting the same rates since we’ve had an agreement with Kaiser,” hospital spokeswoman Becky Barney-Villano said. “Kaiser asked for a rate reduction this time around.”

Mission officials said a financial proposal similar to agreements with other health care providers was rejected by Kaiser Permanente.

“Mission Hospital cannot continue to provide services at rates that will not cover the cost of providing those services,” said Peter Bastone, the hospital’s president.

Kaiser officials declined to comment on the negotiations.

Kaiser’s South County members who need specialty care, from hernia repair to heart surgeries, are sent to the Kaiser Permanente Medical Center in Anaheim.

Should Kaiser fail to reach agreement with another South County hospital by the end of the year, members in the area also would have to go to the Anaheim facility for maternity care.

Mission Hospital, as all hospitals are required to do by law, will continue to accept trauma patients regardless of their insurance plans. Typically, insurers and HMOs require members to go to affiliated hospitals unless an injury or illness is life-threatening.