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"content": "\u003cp>San Francisco supervisors are urging \u003ca href=\"https://www.kqed.org/news/tag/sutter-health\">Sutter Health\u003c/a>’s California Pacific Medical Center to step up safety measures in its upcoming contract with a new union representing interns and residents, spurred by the story of a psychiatry resident who was knocked unconscious in an attack.\u003c/p>\n\u003cp>The Board of Supervisors passed a resolution this month, and in a letter dated June 6 to CPMC executives, including CEO Hamila Kownacki, supervisors urged the hospital system to “address concerns related to safe working conditions for resident physicians and patients.”\u003c/p>\n\u003cp>As part of the background material for the resolution, the supervisors cited the story of Dr. Dani Golomb, a psychiatry resident who was punched, dragged and knocked unconscious while working at a CPMC campus in September 2020. After Golomb shared her story \u003ca href=\"https://www.kqed.org/science/1991739/bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack\">with KQED\u003c/a> in March, state regulators \u003ca href=\"https://www.kqed.org/news/11980953/california-regulators-investigate-sutter-health-over-unreported-assault-on-psychiatry-worker\">launched a subsequent review\u003c/a> into the previously unreported assault.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sutter Health was legally required to file a violent incident report to state regulators within 72 hours, but the California Division of Occupational Safety and Health or Cal/OSHA, has no record of the incident. Sutter Health has acknowledged that the hospital did not initially report Golomb’s assault or injury but said it did note the assault in an injury log filed with Cal/OSHA later in 2020.\u003c/p>\n\u003cp>Golomb suffered a concussion and a traumatic brain injury. She missed more than a year of work as she recovered.[aside postID=news_11989238 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/CMERWorkers01-1020x680.jpg']Board of Supervisors President Aaron Peskin, who co-sponsored the legislation, told KQED in a statement that the city is moving aggressively to staff up its essential health care workers. “But we won’t be able to expand our workforce if the health care system isn’t safe,” he said. “Health care workers who keep us safe and healthy deserve safety in their workplace, too.”\u003c/p>\n\u003cp>He added, “That starts with OSHA enforcement of reporting and tracking of assaults within our hospital network. Transparency and accountability are key.”\u003c/p>\n\u003cp>Golomb, for her part, told KQED that she felt heartened to know about the supervisors’ resolution.\u003c/p>\n\u003cp>“We’re simply asking for respect and dignity from [Sutter Health], and we haven’t really seen that,” she said. “We’ve been negotiating for our contract for months now, and they continuously refuse to put language in the contract about 24/7 security on our inpatient psych unit.”\u003c/p>\n\u003cp>In a statement emailed to KQED, a Sutter Health spokesperson said the hospital is addressing the concerns raised by the residents through ongoing reviews of current security practices, unit rounding and open dialogue regarding additional improvements.\u003c/p>\n\u003cp>The spokesperson added that the hospital system had reached 31 tentative agreements with the union through bargaining sessions, including an article related to employee health, safety and security.\u003c/p>\n\u003cp>“We appreciate the Board of Supervisors’ support of safe work environments and fair pay and benefits for healthcare workers,” the statement said. “We share this commitment and are doing our part to reach a fair contract for our residents, as we value their contributions to providing compassionate and quality patient care.”\u003c/p>\n\u003cp>Golomb and about 15 of her resident colleagues announced in January their plans to unionize and have been negotiating a first contract with the hospital system.\u003c/p>\n\u003cp>They have asked CPMC to increase its safety measures, pressing for a round-the-clock security presence in the inpatient psych unit and an intensive care unit.\u003c/p>\n\u003cp>Sutter Health has said it is committed to a fair contract and safe work environments. The hospital said it spent nearly $40 million to improve security for the unit where Golomb was attacked, purchasing cameras, panic buttons and duress alarms and securing doors. A security officer is now stationed there during the day.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco supervisors are urging \u003ca href=\"https://www.kqed.org/news/tag/sutter-health\">Sutter Health\u003c/a>’s California Pacific Medical Center to step up safety measures in its upcoming contract with a new union representing interns and residents, spurred by the story of a psychiatry resident who was knocked unconscious in an attack.\u003c/p>\n\u003cp>The Board of Supervisors passed a resolution this month, and in a letter dated June 6 to CPMC executives, including CEO Hamila Kownacki, supervisors urged the hospital system to “address concerns related to safe working conditions for resident physicians and patients.”\u003c/p>\n\u003cp>As part of the background material for the resolution, the supervisors cited the story of Dr. Dani Golomb, a psychiatry resident who was punched, dragged and knocked unconscious while working at a CPMC campus in September 2020. After Golomb shared her story \u003ca href=\"https://www.kqed.org/science/1991739/bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack\">with KQED\u003c/a> in March, state regulators \u003ca href=\"https://www.kqed.org/news/11980953/california-regulators-investigate-sutter-health-over-unreported-assault-on-psychiatry-worker\">launched a subsequent review\u003c/a> into the previously unreported assault.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sutter Health was legally required to file a violent incident report to state regulators within 72 hours, but the California Division of Occupational Safety and Health or Cal/OSHA, has no record of the incident. Sutter Health has acknowledged that the hospital did not initially report Golomb’s assault or injury but said it did note the assault in an injury log filed with Cal/OSHA later in 2020.\u003c/p>\n\u003cp>Golomb suffered a concussion and a traumatic brain injury. She missed more than a year of work as she recovered.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Board of Supervisors President Aaron Peskin, who co-sponsored the legislation, told KQED in a statement that the city is moving aggressively to staff up its essential health care workers. “But we won’t be able to expand our workforce if the health care system isn’t safe,” he said. “Health care workers who keep us safe and healthy deserve safety in their workplace, too.”\u003c/p>\n\u003cp>He added, “That starts with OSHA enforcement of reporting and tracking of assaults within our hospital network. Transparency and accountability are key.”\u003c/p>\n\u003cp>Golomb, for her part, told KQED that she felt heartened to know about the supervisors’ resolution.\u003c/p>\n\u003cp>“We’re simply asking for respect and dignity from [Sutter Health], and we haven’t really seen that,” she said. “We’ve been negotiating for our contract for months now, and they continuously refuse to put language in the contract about 24/7 security on our inpatient psych unit.”\u003c/p>\n\u003cp>In a statement emailed to KQED, a Sutter Health spokesperson said the hospital is addressing the concerns raised by the residents through ongoing reviews of current security practices, unit rounding and open dialogue regarding additional improvements.\u003c/p>\n\u003cp>The spokesperson added that the hospital system had reached 31 tentative agreements with the union through bargaining sessions, including an article related to employee health, safety and security.\u003c/p>\n\u003cp>“We appreciate the Board of Supervisors’ support of safe work environments and fair pay and benefits for healthcare workers,” the statement said. “We share this commitment and are doing our part to reach a fair contract for our residents, as we value their contributions to providing compassionate and quality patient care.”\u003c/p>\n\u003cp>Golomb and about 15 of her resident colleagues announced in January their plans to unionize and have been negotiating a first contract with the hospital system.\u003c/p>\n\u003cp>They have asked CPMC to increase its safety measures, pressing for a round-the-clock security presence in the inpatient psych unit and an intensive care unit.\u003c/p>\n\u003cp>Sutter Health has said it is committed to a fair contract and safe work environments. The hospital said it spent nearly $40 million to improve security for the unit where Golomb was attacked, purchasing cameras, panic buttons and duress alarms and securing doors. A security officer is now stationed there during the day.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "California Regulators Investigate Sutter Health Over Unreported Assault on Psychiatry Worker",
"headTitle": "California Regulators Investigate Sutter Health Over Unreported Assault on Psychiatry Worker | KQED",
"content": "\u003cp>California regulators are reviewing Sutter Health’s handling of a violent assault on a psychiatry resident after she \u003ca href=\"https://www.kqed.org/science/1991739/bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack\">shared her story with KQED\u003c/a>.\u003c/p>\n\u003cp>Dani Golomb was brutally beaten and knocked unconscious by a patient on Sept. 5, 2020, while working in the inpatient unit at California Pacific Medical Center. The patient jumped her from behind, shoving Golomb to the floor.[pullquote size=\"medium\" align=\"right\" citation=\"Dani Golomb, psychiatry resident, California Pacific Medical Center\"]‘I had one of these folding metal clipboards. [The patient] grabbed it out of my hand and smashed it repeatedly on my head.’[/pullquote]“I was punched in the head, neck and shoulders,” she told KQED in an interview. “I had one of these folding metal clipboards. [The patient] grabbed it out of my hand and smashed it repeatedly on my head.”\u003c/p>\n\u003cp>Golomb suffered a concussion and a traumatic brain injury. She missed more than a year of work as she recovered.\u003c/p>\n\u003cp>Sutter Health was legally required to file a violent incident report to state regulators within 72 hours, but the California Division of Occupational Safety and Health, or Cal/OSHA, has no record of the incident, the agency confirmed in an email to KQED. Cal/OSHA said it was “looking into the matter.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In an emailed statement, Sutter Health acknowledged that the hospital did not initially report Golomb’s assault or injury but said it did record the assault in an injury log filed with Cal/OSHA.\u003c/p>\n\u003cp>“I think, whether intentionally unreported or not, what upsets me the most is the possibility that more safety measures could have been implemented if Cal/OSHA had been aware of the violence,” Golomb said in an interview this week with KQED. “I think it’s a relief to hear that state regulators are looking into my case. I feel angry that it wasn’t properly reported in the first place.”\u003c/p>\n\u003cfigure id=\"attachment_11980970\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980970\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, poses for a portrait at her home in San Francisco on Feb. 9, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, California lawmakers passed what was touted as the nation’s strongest state workplace violence regulations for health care facilities. The law, SB 1299, was sponsored by the California Nurses Association. It requires hospitals to develop comprehensive workplace violence prevention plans, and it mandates strict reporting requirements for acute care settings, like the inpatient psychiatry unit where Golomb was beaten.[pullquote size=\"medium\" align=\"right\" citation=\"Carmen Comsti, lead regulatory specialist, California Nurses Association\"]‘Enforcement on a basic level has been lax. My sense is that no one at Cal/OSHA is really looking to see whether or not hospitals are reporting or not.’[/pullquote]“I authored legislation to help ensure safer working environments for the nurses and doctors who provide critical care for our communities, but it’s clear that more needs to be done to build on our efforts,” Sen. Alex Padilla, who wrote SB 1299 when he was a state lawmaker, said in a statement. “Physicians on the frontlines of our mental health crisis deserve a safe workplace.”\u003c/p>\n\u003cp>Since 2017, California hospitals have reported roughly 10,000 violent incidents annually to the state. Carmen Comsti, the California Nurses Association’s lead regulatory specialist, said that many hospitals are underreporting violent incidents, and regulators have not been holding facilities accountable.\u003c/p>\n\u003cp>“Enforcement on a basic level has been lax,” she said. “My sense is that no one at Cal/OSHA is really looking to see whether or not hospitals are reporting or not.”[aside label='More on Workplace Safety' tag='workplace-safety']“The violent incident reports are key to the success of implementation of workplace violence prevention plans,” Comsti continued. “[They allow] workers to know what is happening and can engage with their employer to say these things we need to improve.”\u003c/p>\n\u003cp>Golomb and her colleagues have pressed Sutter Health to increase its safety measures. Earlier this month, they delivered a petition to hospital management signed by more than 100 psychiatry residents, fellows and nurses who demanded a round-the-clock security presence in the inpatient psych unit and an intensive care unit.\u003c/p>\n\u003cp>“Our ability to continue to provide the highest standard of care is increasingly threatened by a growing concern for our own safety in our workplace,” the petition said.\u003c/p>\n\u003cp>Sutter claims it has spent nearly $40 million to improve security for the unit where Golomb was attacked, purchasing cameras, panic buttons, duress alarms and securing doors. A security officer is now stationed there during the day.\u003c/p>\n\u003cp>On March 8, the day after KQED’s story on Golomb was published, Warner Thomas, Sutter Health’s president and CEO, sent an email to hospital employees titled, “Keeping you safe from harm at work.”[pullquote size=\"medium\" align=\"right\" citation=\"Dani Golomb, psychiatry resident, California Pacific Medical Center\"]‘My goal since the beginning of all this was to work towards creating a safer environment for my peers, patients, nurses and the rest of our staff.’[/pullquote]The email noted Sutter’s plan to spend an additional $45 million to simplify workplace violence reporting, develop new signage, increase training and expand security officer patrols.\u003c/p>\n\u003cp>“Many of you have also voiced your concerns about safety at our Sutter Health worksites,” Thomas wrote. “I want to thank you for speaking up and talking about your experiences with me and other leaders.”\u003c/p>\n\u003cp>Golomb said there have been “notable improvements” at work, with a more consistent security presence. Residents were also given panic buttons.\u003c/p>\n\u003cp>“My goal since the beginning of all this was to work towards creating a safer environment for my peers, patients, nurses and the rest of our staff,” she said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In an emailed statement, Sutter Health acknowledged that the hospital did not initially report Golomb’s assault or injury but said it did record the assault in an injury log filed with Cal/OSHA.\u003c/p>\n\u003cp>“I think, whether intentionally unreported or not, what upsets me the most is the possibility that more safety measures could have been implemented if Cal/OSHA had been aware of the violence,” Golomb said in an interview this week with KQED. “I think it’s a relief to hear that state regulators are looking into my case. I feel angry that it wasn’t properly reported in the first place.”\u003c/p>\n\u003cfigure id=\"attachment_11980970\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980970\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240209-HOSPITALVIOLENCE-20-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, poses for a portrait at her home in San Francisco on Feb. 9, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, California lawmakers passed what was touted as the nation’s strongest state workplace violence regulations for health care facilities. The law, SB 1299, was sponsored by the California Nurses Association. It requires hospitals to develop comprehensive workplace violence prevention plans, and it mandates strict reporting requirements for acute care settings, like the inpatient psychiatry unit where Golomb was beaten.\u003c/p>\u003c/div>",
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"content": "‘Enforcement on a basic level has been lax. My sense is that no one at Cal/OSHA is really looking to see whether or not hospitals are reporting or not.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I authored legislation to help ensure safer working environments for the nurses and doctors who provide critical care for our communities, but it’s clear that more needs to be done to build on our efforts,” Sen. Alex Padilla, who wrote SB 1299 when he was a state lawmaker, said in a statement. “Physicians on the frontlines of our mental health crisis deserve a safe workplace.”\u003c/p>\n\u003cp>Since 2017, California hospitals have reported roughly 10,000 violent incidents annually to the state. Carmen Comsti, the California Nurses Association’s lead regulatory specialist, said that many hospitals are underreporting violent incidents, and regulators have not been holding facilities accountable.\u003c/p>\n\u003cp>“Enforcement on a basic level has been lax,” she said. “My sense is that no one at Cal/OSHA is really looking to see whether or not hospitals are reporting or not.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The violent incident reports are key to the success of implementation of workplace violence prevention plans,” Comsti continued. “[They allow] workers to know what is happening and can engage with their employer to say these things we need to improve.”\u003c/p>\n\u003cp>Golomb and her colleagues have pressed Sutter Health to increase its safety measures. Earlier this month, they delivered a petition to hospital management signed by more than 100 psychiatry residents, fellows and nurses who demanded a round-the-clock security presence in the inpatient psych unit and an intensive care unit.\u003c/p>\n\u003cp>“Our ability to continue to provide the highest standard of care is increasingly threatened by a growing concern for our own safety in our workplace,” the petition said.\u003c/p>\n\u003cp>Sutter claims it has spent nearly $40 million to improve security for the unit where Golomb was attacked, purchasing cameras, panic buttons, duress alarms and securing doors. A security officer is now stationed there during the day.\u003c/p>\n\u003cp>On March 8, the day after KQED’s story on Golomb was published, Warner Thomas, Sutter Health’s president and CEO, sent an email to hospital employees titled, “Keeping you safe from harm at work.”\u003c/p>\u003c/div>",
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"content": "‘My goal since the beginning of all this was to work towards creating a safer environment for my peers, patients, nurses and the rest of our staff.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The email noted Sutter’s plan to spend an additional $45 million to simplify workplace violence reporting, develop new signage, increase training and expand security officer patrols.\u003c/p>\n\u003cp>“Many of you have also voiced your concerns about safety at our Sutter Health worksites,” Thomas wrote. “I want to thank you for speaking up and talking about your experiences with me and other leaders.”\u003c/p>\n\u003cp>Golomb said there have been “notable improvements” at work, with a more consistent security presence. Residents were also given panic buttons.\u003c/p>\n\u003cp>“My goal since the beginning of all this was to work towards creating a safer environment for my peers, patients, nurses and the rest of our staff,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"disqusTitle": "First Came Sutter Health. Next Could Be Stanford. Why Bay Area Nurses Are Walking Off the Job",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">Across Northern California, over 8,000 Sutter Health nurses and other workers at 15 facilities went on a one-day strike Monday. Another 5,000 workers from Stanford Health Care and Lucile Packard Children’s Hospital are set to walk off the job next Monday, after contract negotiations came to a halt. \u003c/span>\u003c/p>\n\u003cp>The Sutter strike caused the nonprofit to hire temporary workers to make up for the staffing shortage. The nurses’ labor contract with Sutter expired in February, and negotiations have been ongoing since June 2021. Some of the issues being discussed are \u003ca href=\"https://www.kqed.org/news/11901728/nurses-concerned-about-working-conditions\">workplace protections\u003c/a> related to the pandemic, including personal protective equipment, minimal staffing and contact tracing. [pullquote size=\"medium\" align=\"right\" citation=\"Joanne Spetz, director, Philip R. Lee Institute for Health Policy Studies at UCSF\"]'Two years of working through pandemic conditions and all of the death and the stress and, in some cases, hostile patients and families and other experiences that nurses have had, a lot of them are saying, we need to be better compensated and have better protections in our work environments to feel like we want to stay in these jobs.'[/pullquote]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">KQED's Natalia Navarro sat down with Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at UCSF, to talk more about what's causing the labor issues in the nursing profession.\u003c/span>\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>NATALIA NAVARRO: \u003c/strong>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p0-0\"}]'>\u003cstrong>Can you just set up the basic stakes for us here? What are health workers asking for that they're not getting?\u003c/strong> \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>JOANNE SPETZ\u003c/strong>: \u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p1-0\"}]'>Health workers had a very difficult and challenging time through the pandemic. They frequently were short-staffed — not necessarily that their employers intended to short-staff, but with so many people going out on quarantine and how difficult it was to get traveling and temporary staff to fill in the gaps, there has been a lot of stress and a lot of short-staffing and a lot of concern about turnover and the long-term sustainability of the workforce. \u003c/span>[aside postID=\"news_11892581\" label=\"Related Posts\"]\u003cstrong>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p2-0\"}]'>Along that vein, we have been hearing about a California nursing shortage. A 2021 CalMatters story said that \u003ca href=\"https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/\">the understaffing was at a \"crisis point,\"\u003c/a> and that was a year ago. Can you talk to me about some of the driving factors behind this issue? \u003c/span>\u003c/strong>\u003c/p>\n\u003cp>We did a survey in late 2020, and what we found at that point is a lot of nurses that were close to retirement already left. I think there were a lot of nurses within a year or two of retirement who looked at the situation and said, \"I'm older, I'm at higher risk, I don't want to work in these circumstances,\" and they left the workforce. So that left hospitals already with short-staffing issues.\u003c/p>\n\u003cp>And then when we had the more contagious variants, we had a lot of concerns about nurses going out on basically quarantines. And that left the nurses who were not on quarantine with even fewer nurses to help out with the work. In the long term, two years of working through pandemic conditions and all of the death and the stress and, in some cases, hostile patients and families and other experiences that nurses have had, a lot of them are saying, \"We need to be better compensated and have better protections in our work environments to feel like we want to stay in these jobs.\"\u003c/p>\n\u003cp>The analysis that we did based on that 2020 data suggested that we may have a pretty significant shortage for the next five or six years, but we're waiting for newly graduated nurses to come online and take up the jobs that have been so rapidly vacated. And that was more than a year ago that we did that analysis. So we don't know yet if things have gotten worse or, perhaps, as things are beginning to settle down with the pandemic, maybe things are going to start looking a little bit better. Hopefully, we'll be able to get some data to learn more about that over the next six or nine months or so.\u003c/p>\n\u003cp>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p4-0\"}]'>\u003cstrong>These two groups, these two unions of nurses that are either striking or considering striking very soon, one of their big concerns is access to PPE, other protective equipment. Tell me, what is the issue with that at this point in the pandemic?\u003c/strong>\u003c/span>\u003c/p>\n\u003cp class=\"tr-paragraph\" data-pm-slice='2 2 [\"paragraph-wrapper\",null]'>Well, fortunately, a lot of those concerns did calm down after the first six or nine months or so when PPE was so impossible to get ahold of. That said, these kinds of concerns can continue to exist. And I think for a lot of health care workers, they may have concerns about relaxing some of the restrictions that may bring family members in who aren't required to have equipment. And if that's happening, then the nursing staff and the other health professionals may feel like they want more protection because the people around them may be less protected. I think that is going to be an ongoing concern, especially about the quality of the equipment and its availability and trying to move into a more sustainable pattern of of use.\u003c/p>\n\u003cp class=\"tr-paragraph\" data-pm-slice='2 2 [\"paragraph-wrapper\",null]'>Depending on the situation, the strikes coming up are generally registered nurses and generally in hospitals. But there are other settings like nursing homes that have been hit really hard, and there was a long period of time where family members were really not allowed to go into nursing homes. What people haven't really talked about for nurses and nursing assistants in those settings is how much extra workload that put on those staff. Often, family members go in and help take a meal with a loved one and help feed them and help provide other services or other support to their family member, which relieve some of the workload and the burden for the paid staff in a nursing home setting. When the family members were kicked out, the nursing staff had all that extra work that they needed to do, and there was no emotional support for the family members beyond the staff, so it's incredibly burdensome. So I think that's another area where we don't see any strikes coming up in the next week or two, but I think we really need to keep a close eye on what's going to happen in nursing homes next.\u003c/p>\n\u003cp>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p4-0\"}]'>\u003cstrong>Let's talk about the responses from hospital administrators. Stanford Health Care has doubled down on their plan to cut off health insurance coverage for the nurses if they go through with the strike next week. Of course, there's been a big backlash to that decision. Have you seen any responses from hospitals or hospital systems that have worked at improving conditions for nurses?\u003c/strong> \u003c/span>\u003c/p>\n\u003cp>I think a lot of those systems are trying to make various improvements, although it's not always advertised what improvements that they're making until there are allegations about problems. I'm at University of California, San Francisco, and so of course, I may be somewhat biased, but I know that our leadership has been putting a lot of work into trying to have adequate staffing and trying to promote a really highly respectful culture and make sure that staff understand how appreciated they are. But I can't entirely speak to the responses in the other organizations cutting off health benefits. First, there may be some practical and legal issues about trying to do that with any rapidity. But the last time Stanford had a big strike, that strike went on for more than a year. So they and the administration there may be really wanting to come down hard in trying to deter a strike because the last one was so drawn out and so painful for them.\u003c/p>\n\u003cp>\u003cem>KQED's Natalia Navarro, Sara Hossaini and Mary Franklin Harvin contributed reporting to this story.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">Across Northern California, over 8,000 Sutter Health nurses and other workers at 15 facilities went on a one-day strike Monday. Another 5,000 workers from Stanford Health Care and Lucile Packard Children’s Hospital are set to walk off the job next Monday, after contract negotiations came to a halt. \u003c/span>\u003c/p>\n\u003cp>The Sutter strike caused the nonprofit to hire temporary workers to make up for the staffing shortage. The nurses’ labor contract with Sutter expired in February, and negotiations have been ongoing since June 2021. Some of the issues being discussed are \u003ca href=\"https://www.kqed.org/news/11901728/nurses-concerned-about-working-conditions\">workplace protections\u003c/a> related to the pandemic, including personal protective equipment, minimal staffing and contact tracing. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">KQED's Natalia Navarro sat down with Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at UCSF, to talk more about what's causing the labor issues in the nursing profession.\u003c/span>\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>NATALIA NAVARRO: \u003c/strong>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p0-0\"}]'>\u003cstrong>Can you just set up the basic stakes for us here? What are health workers asking for that they're not getting?\u003c/strong> \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>JOANNE SPETZ\u003c/strong>: \u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p1-0\"}]'>Health workers had a very difficult and challenging time through the pandemic. They frequently were short-staffed — not necessarily that their employers intended to short-staff, but with so many people going out on quarantine and how difficult it was to get traveling and temporary staff to fill in the gaps, there has been a lot of stress and a lot of short-staffing and a lot of concern about turnover and the long-term sustainability of the workforce. \u003c/span>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cstrong>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p2-0\"}]'>Along that vein, we have been hearing about a California nursing shortage. A 2021 CalMatters story said that \u003ca href=\"https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/\">the understaffing was at a \"crisis point,\"\u003c/a> and that was a year ago. Can you talk to me about some of the driving factors behind this issue? \u003c/span>\u003c/strong>\u003c/p>\n\u003cp>We did a survey in late 2020, and what we found at that point is a lot of nurses that were close to retirement already left. I think there were a lot of nurses within a year or two of retirement who looked at the situation and said, \"I'm older, I'm at higher risk, I don't want to work in these circumstances,\" and they left the workforce. So that left hospitals already with short-staffing issues.\u003c/p>\n\u003cp>And then when we had the more contagious variants, we had a lot of concerns about nurses going out on basically quarantines. And that left the nurses who were not on quarantine with even fewer nurses to help out with the work. In the long term, two years of working through pandemic conditions and all of the death and the stress and, in some cases, hostile patients and families and other experiences that nurses have had, a lot of them are saying, \"We need to be better compensated and have better protections in our work environments to feel like we want to stay in these jobs.\"\u003c/p>\n\u003cp>The analysis that we did based on that 2020 data suggested that we may have a pretty significant shortage for the next five or six years, but we're waiting for newly graduated nurses to come online and take up the jobs that have been so rapidly vacated. And that was more than a year ago that we did that analysis. So we don't know yet if things have gotten worse or, perhaps, as things are beginning to settle down with the pandemic, maybe things are going to start looking a little bit better. Hopefully, we'll be able to get some data to learn more about that over the next six or nine months or so.\u003c/p>\n\u003cp>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p4-0\"}]'>\u003cstrong>These two groups, these two unions of nurses that are either striking or considering striking very soon, one of their big concerns is access to PPE, other protective equipment. Tell me, what is the issue with that at this point in the pandemic?\u003c/strong>\u003c/span>\u003c/p>\n\u003cp class=\"tr-paragraph\" data-pm-slice='2 2 [\"paragraph-wrapper\",null]'>Well, fortunately, a lot of those concerns did calm down after the first six or nine months or so when PPE was so impossible to get ahold of. That said, these kinds of concerns can continue to exist. And I think for a lot of health care workers, they may have concerns about relaxing some of the restrictions that may bring family members in who aren't required to have equipment. And if that's happening, then the nursing staff and the other health professionals may feel like they want more protection because the people around them may be less protected. I think that is going to be an ongoing concern, especially about the quality of the equipment and its availability and trying to move into a more sustainable pattern of of use.\u003c/p>\n\u003cp class=\"tr-paragraph\" data-pm-slice='2 2 [\"paragraph-wrapper\",null]'>Depending on the situation, the strikes coming up are generally registered nurses and generally in hospitals. But there are other settings like nursing homes that have been hit really hard, and there was a long period of time where family members were really not allowed to go into nursing homes. What people haven't really talked about for nurses and nursing assistants in those settings is how much extra workload that put on those staff. Often, family members go in and help take a meal with a loved one and help feed them and help provide other services or other support to their family member, which relieve some of the workload and the burden for the paid staff in a nursing home setting. When the family members were kicked out, the nursing staff had all that extra work that they needed to do, and there was no emotional support for the family members beyond the staff, so it's incredibly burdensome. So I think that's another area where we don't see any strikes coming up in the next week or two, but I think we really need to keep a close eye on what's going to happen in nursing homes next.\u003c/p>\n\u003cp>\u003cspan data-pm-slice='1 1 [\"paragraph-wrapper\",null,\"paragraph\",{\"id\":\"p4-0\"}]'>\u003cstrong>Let's talk about the responses from hospital administrators. Stanford Health Care has doubled down on their plan to cut off health insurance coverage for the nurses if they go through with the strike next week. Of course, there's been a big backlash to that decision. Have you seen any responses from hospitals or hospital systems that have worked at improving conditions for nurses?\u003c/strong> \u003c/span>\u003c/p>\n\u003cp>I think a lot of those systems are trying to make various improvements, although it's not always advertised what improvements that they're making until there are allegations about problems. I'm at University of California, San Francisco, and so of course, I may be somewhat biased, but I know that our leadership has been putting a lot of work into trying to have adequate staffing and trying to promote a really highly respectful culture and make sure that staff understand how appreciated they are. But I can't entirely speak to the responses in the other organizations cutting off health benefits. First, there may be some practical and legal issues about trying to do that with any rapidity. But the last time Stanford had a big strike, that strike went on for more than a year. So they and the administration there may be really wanting to come down hard in trying to deter a strike because the last one was so drawn out and so painful for them.\u003c/p>\n\u003cp>\u003cem>KQED's Natalia Navarro, Sara Hossaini and Mary Franklin Harvin contributed reporting to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Sutter Health, a large nonprofit health care system with 24 hospitals, 34 surgery centers and 5,500 physicians across Northern California, has reached a preliminary settlement agreement in a closely watched antitrust case brought by self-funded employers and later joined by California's Office of the Attorney General.\u003c/p>\n\u003cp>The agreement was announced in San Francisco Superior Court on Wednesday, just before opening arguments were expected to begin.\u003c/p>\n\u003cp>Details have not been made public, and the parties declined to talk to reporters. Superior Court Judge Anne-Christine Massullo told the jury that details likely will be made public during approval hearings in February or March.\u003c/p>\n\u003cp>There were audible cheers from the jury following the announcement that the trial, which was expected to last for three months, would not continue.\u003c/p>\n\u003cp>Sutter, which is based in Sacramento, stood accused of violating California's antitrust laws by using its market power to illegally drive up prices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Health care costs in Northern California, where Sutter is dominant, are 20% to 30% higher than in Southern California, even after adjusting for cost of living, according to a \u003ca href=\"http://petris.org/wp-content/uploads/2018/03/CA-Consolidation-Full-Report_03.26.18.pdf\">2018 study\u003c/a> from the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at UC Berkeley, that was cited in the complaint.\u003c/p>\n\u003cp>The case was a massive undertaking, representing years of work and millions of pages of documents, California Attorney General Xavier Becerra said before the trial. Sutter was expected to face damages of up to $2.7 billion.\u003c/p>\n\u003cp>Sutter Health consistently denied the allegations and argued that it used its market power to improve care for patients and expand access to people in rural areas. The chain of health care facilities had $13 billion in operating revenue in 2018.\u003c/p>\n\u003cp>The case was expected to have nationwide implications on how hospital systems negotiate prices with insurers. It is not yet clear what effect, if any, a settlement agreement would have on Sutter's tactics or those of other large systems.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a> \u003cem>is a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.\u003c/em> \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospital+Giant+Sutter+Health+Agrees+To+Settlement+In+Big+Antitrust+Fight&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Health care costs in Northern California, where Sutter is dominant, are 20% to 30% higher than in Southern California, even after adjusting for cost of living, according to a \u003ca href=\"http://petris.org/wp-content/uploads/2018/03/CA-Consolidation-Full-Report_03.26.18.pdf\">2018 study\u003c/a> from the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at UC Berkeley, that was cited in the complaint.\u003c/p>\n\u003cp>The case was a massive undertaking, representing years of work and millions of pages of documents, California Attorney General Xavier Becerra said before the trial. Sutter was expected to face damages of up to $2.7 billion.\u003c/p>\n\u003cp>Sutter Health consistently denied the allegations and argued that it used its market power to improve care for patients and expand access to people in rural areas. The chain of health care facilities had $13 billion in operating revenue in 2018.\u003c/p>\n\u003cp>The case was expected to have nationwide implications on how hospital systems negotiate prices with insurers. It is not yet clear what effect, if any, a settlement agreement would have on Sutter's tactics or those of other large systems.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a> \u003cem>is a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.\u003c/em> \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospital+Giant+Sutter+Health+Agrees+To+Settlement+In+Big+Antitrust+Fight&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Sues Sutter Health Alleging Excessive Pricing",
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"content": "\u003cp>California’s Attorney General Xavier Becerra announced a lawsuit Friday against Sutter Health, alleging the hospital giant engaged in anti-competitive conduct that drove up prices for patients and employers in the state.\u003c/p>\n\u003cp>The lawsuit marked a bold move by the state's Attorney General against the dominant health care system in Northern California as concerns mount nationally about consolidation among hospitals, insurers and other industry middlemen.\u003c/p>\n\u003cp>“It’s time to hold health care corporations accountable,” Becerra said at a news conference Friday. “We seek to stop Sutter from continuing this illegal conduct.”\u003c/p>\n\u003cp>Sutter, which owns 24 hospitals, reported a net income of $893 million last year on $12.4 billion in revenue.\u003c/p>\n\u003cp>In a statement Friday, Sutter said it had not yet seen the state’s complaint and couldn’t comment on specific claims.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Overall, Sutter said, “healthy competition and choice exists across Northern California” for consumers seeking medical care, and that its charges for an inpatient stay are lower than what other nearby hospitals charge.\u003c/p>\n\u003cp>“Sutter Health is proud to save patients, government payers and health plans hundreds of millions of dollars each year by providing more efficient and integrated care,” the statement said.\u003c/p>\n\u003cp>This high-profile legal fight will attract attention from employers and policymakers across the country amid growing alarm about the financial implications of industry consolidation. Large health systems are gaining market clout and the ability to raise prices by acquiring more hospitals, outpatient surgery centers and physicians’ offices.\u003c/p>\n\u003cp>Martin Gaynor, a health care economist at Carnegie Mellon University, said California’s lawsuit may portend more litigation at the state level.\u003c/p>\n\u003cp>“There are a number of markets in the U.S. that are dominated by one very large, powerful health system,” Gaynor said. “It could be that we’re going to see a new level of activity by state antitrust enforcers looking at competition in their own backyards.”\u003c/p>\n\u003cp>The \u003ca href=\"https://californiahealthline.org/news/major-employers-decry-sutter-healths-tactics-in-dispute-over-prices/\" target=\"_blank\" rel=\"noopener\">complaints\u003c/a> about Sutter’s high prices and market power have persisted for years.\u003c/p>\n\u003cp>A \u003ca href=\"https://khn.org/news/as-hospital-chains-grow-so-do-their-prices-for-care/\" target=\"_blank\" rel=\"noopener\">2016 study\u003c/a> found that hospital prices at Sutter and Dignity Health, the two biggest hospital chains in California, were 25 percent higher than at other hospitals around the state. Researchers at the University of Southern California said the giant health systems used their market power to drive up prices — making the average patient admission at both chains nearly $4,000 more expensive.\u003c/p>\n\u003cfigure id=\"attachment_11659158\" class=\"wp-caption alignleft\" style=\"max-width: 500px\">\u003cimg class=\"size-full wp-image-11659158\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/03/becerra_1350.jpg\" alt=\"\" width=\"500\" height=\"333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350.jpg 500w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-375x250.jpg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">“It’s time to hold health care corporations accountable,” California Attorney General Xavier Becerra said at a news conference Friday. \u003ccite>(Ana B. Ibarra/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This week, researchers at University of California-Berkeley issued a \u003ca href=\"http://petris.org/wp-content/uploads/2018/03/CA-Consolidation-Full-Report_03.26.18.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> that examined the consolidation of the hospital, physician and health insurance markets in California from 2010 to 2016. The authors said 44 of California’s 58 counties had “highly concentrated” hospital markets.\u003c/p>\n\u003cp>The problem is worse in Northern California and the report said prices for medical procedures are often up to 30 percent higher there than in Southern California, which has more competition.\u003c/p>\n\u003cp>“Consumers are paying more for health care as a result of market consolidation. It is now time for regulators and legislators to take action,” according to the report by the Petris Center on Health Care Markets and Consumer Welfare at UC-Berkeley.\u003c/p>\n\u003cp>After the report was issued Monday, Becerra said his office would be reviewing those findings and pledged to apply more scrutiny to health care mergers and anti-competitive practices across the state.\u003c/p>\n\u003cp>Sutter Health has gobbled up doctor practices across the Bay Area, gaining market muscle that has pushed costs upward. Obstetricians employed by Sutter Health, for example, are reimbursed about three times more for the same service than independent doctors, according to a \u003ca href=\"https://khn.org/news/guess-who-pays-the-price-when-hospital-giants-hire-your-private-practitioner/\">KHN review of OB-GYN charges\u003c/a> on several insurers’ online cost estimators. It’s a key reason why Northern California is the \u003ca href=\"https://khn.org/news/if-you-want-to-spend-a-bundle-on-your-bundle-of-joy-go-to-northern-california/\">most expensive place\u003c/a> in the country to have a baby.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Becerra’s lawsuit could build off a similar \u003ca href=\"https://khn.org/news/health-giant-sutter-destroys-evidence-in-high-profile-antitrust-case-over-high-prices/\" target=\"_blank\" rel=\"noopener\">civil case\u003c/a> filed in 2014 by a grocery workers’ health plan.\u003c/p>\n\u003cp>The plaintiffs in that case, scheduled for trial next year, allege Sutter is violating antitrust and fair competition laws. The plaintiffs have been requesting documents related to contracting practices, such as “gag clauses” that prevent patients from seeking negotiated rates and choosing a cheaper provider. They also are challenging “all-or-nothing” terms that require every facility in a health system to be included in insurance networks.\u003c/p>\n\u003cp>In November, the \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\" target=\"_blank\" rel=\"noopener\">state judge\u003c/a> handling the grocery workers’ case said Sutter was “grossly reckless” when it intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in the lawsuit. San Francisco County Superior Court Judge Curtis E.A. Karnow said Sutter destroyed documents “knowing that the evidence was relevant to antitrust issues. … There is no good explanation for the specific and unusual destruction here.”\u003c/p>\n\u003cp>The lead plaintiffs, the United Food and Commercial Workers and its Employers Benefit Trust, are a joint employer-union health plan that represents more than 60,000 employees, dependents and retirees. The court certified its case as a class action in August, allowing hundreds of other employers and self-funded health plans to potentially benefit from the litigation.\u003c/p>\n\u003cp>In addition to its 24 hospitals, Sutter’s nonprofit health system has 35 surgery centers, 32 urgent-care clinics and more than 5,000 physicians in its network.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>California Healthline reporter Ana Ibarra and KHN senior correspondent Jenny Gold contributed reporting.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Attorney General Xavier Becerra alleges the hospital giant engaged in anti-competitive conduct that drove up prices for patients and employers in the state.",
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"nprByline": "\u003cstrong/>\u003ca href=\"https://californiahealthline.org/news/author/chad-terhune/\">Chad Terhune\u003c/a>\u003c/strong>\u003cbr/>California Healthline\u003c/br>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s Attorney General Xavier Becerra announced a lawsuit Friday against Sutter Health, alleging the hospital giant engaged in anti-competitive conduct that drove up prices for patients and employers in the state.\u003c/p>\n\u003cp>The lawsuit marked a bold move by the state's Attorney General against the dominant health care system in Northern California as concerns mount nationally about consolidation among hospitals, insurers and other industry middlemen.\u003c/p>\n\u003cp>“It’s time to hold health care corporations accountable,” Becerra said at a news conference Friday. “We seek to stop Sutter from continuing this illegal conduct.”\u003c/p>\n\u003cp>Sutter, which owns 24 hospitals, reported a net income of $893 million last year on $12.4 billion in revenue.\u003c/p>\n\u003cp>In a statement Friday, Sutter said it had not yet seen the state’s complaint and couldn’t comment on specific claims.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Overall, Sutter said, “healthy competition and choice exists across Northern California” for consumers seeking medical care, and that its charges for an inpatient stay are lower than what other nearby hospitals charge.\u003c/p>\n\u003cp>“Sutter Health is proud to save patients, government payers and health plans hundreds of millions of dollars each year by providing more efficient and integrated care,” the statement said.\u003c/p>\n\u003cp>This high-profile legal fight will attract attention from employers and policymakers across the country amid growing alarm about the financial implications of industry consolidation. Large health systems are gaining market clout and the ability to raise prices by acquiring more hospitals, outpatient surgery centers and physicians’ offices.\u003c/p>\n\u003cp>Martin Gaynor, a health care economist at Carnegie Mellon University, said California’s lawsuit may portend more litigation at the state level.\u003c/p>\n\u003cp>“There are a number of markets in the U.S. that are dominated by one very large, powerful health system,” Gaynor said. “It could be that we’re going to see a new level of activity by state antitrust enforcers looking at competition in their own backyards.”\u003c/p>\n\u003cp>The \u003ca href=\"https://californiahealthline.org/news/major-employers-decry-sutter-healths-tactics-in-dispute-over-prices/\" target=\"_blank\" rel=\"noopener\">complaints\u003c/a> about Sutter’s high prices and market power have persisted for years.\u003c/p>\n\u003cp>A \u003ca href=\"https://khn.org/news/as-hospital-chains-grow-so-do-their-prices-for-care/\" target=\"_blank\" rel=\"noopener\">2016 study\u003c/a> found that hospital prices at Sutter and Dignity Health, the two biggest hospital chains in California, were 25 percent higher than at other hospitals around the state. Researchers at the University of Southern California said the giant health systems used their market power to drive up prices — making the average patient admission at both chains nearly $4,000 more expensive.\u003c/p>\n\u003cfigure id=\"attachment_11659158\" class=\"wp-caption alignleft\" style=\"max-width: 500px\">\u003cimg class=\"size-full wp-image-11659158\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/03/becerra_1350.jpg\" alt=\"\" width=\"500\" height=\"333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350.jpg 500w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/03/becerra_1350-375x250.jpg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">“It’s time to hold health care corporations accountable,” California Attorney General Xavier Becerra said at a news conference Friday. \u003ccite>(Ana B. Ibarra/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This week, researchers at University of California-Berkeley issued a \u003ca href=\"http://petris.org/wp-content/uploads/2018/03/CA-Consolidation-Full-Report_03.26.18.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> that examined the consolidation of the hospital, physician and health insurance markets in California from 2010 to 2016. The authors said 44 of California’s 58 counties had “highly concentrated” hospital markets.\u003c/p>\n\u003cp>The problem is worse in Northern California and the report said prices for medical procedures are often up to 30 percent higher there than in Southern California, which has more competition.\u003c/p>\n\u003cp>“Consumers are paying more for health care as a result of market consolidation. It is now time for regulators and legislators to take action,” according to the report by the Petris Center on Health Care Markets and Consumer Welfare at UC-Berkeley.\u003c/p>\n\u003cp>After the report was issued Monday, Becerra said his office would be reviewing those findings and pledged to apply more scrutiny to health care mergers and anti-competitive practices across the state.\u003c/p>\n\u003cp>Sutter Health has gobbled up doctor practices across the Bay Area, gaining market muscle that has pushed costs upward. Obstetricians employed by Sutter Health, for example, are reimbursed about three times more for the same service than independent doctors, according to a \u003ca href=\"https://khn.org/news/guess-who-pays-the-price-when-hospital-giants-hire-your-private-practitioner/\">KHN review of OB-GYN charges\u003c/a> on several insurers’ online cost estimators. It’s a key reason why Northern California is the \u003ca href=\"https://khn.org/news/if-you-want-to-spend-a-bundle-on-your-bundle-of-joy-go-to-northern-california/\">most expensive place\u003c/a> in the country to have a baby.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Becerra’s lawsuit could build off a similar \u003ca href=\"https://khn.org/news/health-giant-sutter-destroys-evidence-in-high-profile-antitrust-case-over-high-prices/\" target=\"_blank\" rel=\"noopener\">civil case\u003c/a> filed in 2014 by a grocery workers’ health plan.\u003c/p>\n\u003cp>The plaintiffs in that case, scheduled for trial next year, allege Sutter is violating antitrust and fair competition laws. The plaintiffs have been requesting documents related to contracting practices, such as “gag clauses” that prevent patients from seeking negotiated rates and choosing a cheaper provider. They also are challenging “all-or-nothing” terms that require every facility in a health system to be included in insurance networks.\u003c/p>\n\u003cp>In November, the \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\" target=\"_blank\" rel=\"noopener\">state judge\u003c/a> handling the grocery workers’ case said Sutter was “grossly reckless” when it intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in the lawsuit. San Francisco County Superior Court Judge Curtis E.A. Karnow said Sutter destroyed documents “knowing that the evidence was relevant to antitrust issues. … There is no good explanation for the specific and unusual destruction here.”\u003c/p>\n\u003cp>The lead plaintiffs, the United Food and Commercial Workers and its Employers Benefit Trust, are a joint employer-union health plan that represents more than 60,000 employees, dependents and retirees. The court certified its case as a class action in August, allowing hundreds of other employers and self-funded health plans to potentially benefit from the litigation.\u003c/p>\n\u003cp>In addition to its 24 hospitals, Sutter’s nonprofit health system has 35 surgery centers, 32 urgent-care clinics and more than 5,000 physicians in its network.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>California Healthline reporter Ana Ibarra and KHN senior correspondent Jenny Gold contributed reporting.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Sutter Health intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in a lawsuit that accuses the giant Northern California health system of abusing its market power and charging inflated prices, according to a state judge.\u003c/p>\n\u003cp>In a \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\">ruling this week\u003c/a>, San Francisco County Superior Court Judge Curtis E.A. Karnow said Sutter destroyed documents “knowing that the evidence was relevant to antitrust issues. … There is no good explanation for the specific and unusual destruction here.”\u003c/p>\n\u003cp>Karnow cited an internal email by a Sutter employee who said she was “running and hiding” after ordering the records destroyed in 2015. “The most generous interpretation to Sutter is that it was grossly reckless,” the judge wrote in his 12-page ruling.\u003c/p>\n\u003cp>Sutter, which has 24 hospitals and nearly $12 billion in annual revenue, said the destruction was a regrettable mistake.\u003c/p>\n\u003cp>Employers and policymakers across the country are closely watching this legal fight amid growing concern about the financial implications of industry consolidation. Large health systems are gaining market clout and the ability to raise prices by acquiring more hospitals, outpatient surgery centers and physician offices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s stunning what Sutter did to cover up incriminating documents in this case,” said Richard Grossman, the lead plaintiffs’ lawyer representing a class of more than 1,500 employer-funded health plans.\u003c/p>\n\u003cp>In April 2014, a grocery workers’ health plan sued Sutter and alleged it was violating antitrust and unfair competition laws. The plaintiffs began requesting documents related to contracting practices, such as “gag clauses” that prevent patients from seeing negotiated rates and choosing a cheaper provider and “all-or-nothing” terms that require every facility in a health system to be included in insurance networks \u003c/p>\n\u003cp>Sutter disputes the broader allegations in the lawsuit over its market conduct and said its charges are in line with its competitors’.\u003c/p>\n\u003cp>The judge said that in 2015 \u003ca href=\"https://www.youtube.com/watch?v=hLtEtJgW7no\">Melissa Brendt\u003c/a>, Sutter’s chief contracting officer in the managed-care department, and an assistant general counsel, Daniela Almeida, authorized Brendt’s executive assistant to destroy 10 years’ worth of managed-care documents going back to 1995. The company earlier had scheduled the documents to be destroyed in 2035 — 20 years later.\u003c/p>\n\u003cp>The executive assistant, Sina Santagata, testified in a deposition she wasn’t aware of any other time in her 17 years at Sutter when the managed-care department destroyed records held in storage.\u003c/p>\n\u003cp>In his \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\">Nov. 13 ruling\u003c/a> against Sutter, the judge singled out an email by Santagata as “particularly noteworthy.”\u003c/p>\n\u003cp>The executive assistant emailed Brendt, the chief contracting officer, on July 30, 2015, after sending the order to destroy the records. She wrote, “I’ve pushed the button … if someone is in need of a box between 3/15/95 & 11/23/05 … I’m running and hiding. … ‘Fingers crossed’ that I haven’t authorized something the FTC will hunt me down for.”\u003c/p>\n\u003cp>The Federal Trade Commission (FTC) enforces antitrust laws in health care to prevent hospitals, drugmakers and other industry players from engaging in anti-competitive behavior that could harm consumers.\u003c/p>\n\u003cp>Santagata testified that she was being “sarcastic” in her email, and Sutter told the judge that the FTC reference was just a “joke.”\u003c/p>\n\u003cp>Karnow saw no humor in it. “There are infinite topics for jokes, and the choice of this one is strong evidence” in the plaintiffs’ favor, he wrote in his order Monday.\u003c/p>\n\u003cp>As part of his sanctions against Sutter, the judge ordered the health system to examine \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/plaintiffs-motion-for-sutter-sanctions.pdf\">email\u003c/a> backup tapes covering 2002 through 2005 to search for documents on some of the same topics as the destroyed records. Also, Karnow said he will consider a plaintiffs’ motion for issuing jury instructions that are adverse to Sutter in light of the document destruction. The trial is scheduled for June 2019.\u003c/p>\n\u003cp>“The record shows that Sutter’s conduct was more than just an inadvertent error,” Karnow wrote.\u003c/p>\n\u003cp>Sutter spokeswoman Karen Garner said the incident was a “mistake made as part of a routine destruction of old paper records” and the Sacramento-based health system disclosed the error as soon as it was discovered.\u003c/p>\n\u003cp>“We regret that as part of a routine archiving process we failed to preserve some boxes of decades-old hard-copy documents,” Garner said.\u003c/p>\n\u003cp>The United Food and Commercial Workers and its Employers Benefit Trust initially filed the case against Sutter in 2014. The joint employer-union health plan represents more than 60,000 employees, dependents and retirees. The court certified the case as a class action in August, allowing hundreds of other employers and self-funded health plans to potentially benefit from the litigation.\u003c/p>\n\u003cp>In addition to its 24 hospitals, Sutter’s nonprofit health system has 35 surgery centers and more than 5,000 physicians in its network. It reported $11.9 billion in revenue last year and income of $554 million.\u003c/p>\n\u003cp>Grossman, the plaintiffs’ counsel, said he welcomed the judge’s ruling. But he said much of the evidence is irreplaceable, particularly handwritten notes from negotiating sessions and meetings involving key Sutter executives.\u003c/p>\n\u003cp>He said those records covered a critical period in the early 2000s when there was a “sea change in Sutter’s contracting strategy” and it implemented provisions that insulated the health system from price competition.\u003c/p>\n\u003cp>“This was groundbreaking in the industry,” Grossman said. “Until we address the anti-competitive behavior of entities like Sutter, we will not solve the problem of high costs in health care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The plaintiffs are seeking to recover hundreds of millions of dollars from Sutter from what it claims are illegally inflated prices. The lawsuit alleges that an overnight hospital stay at Sutter hospitals in San Francisco or Sacramento costs at least 38 percent more than a comparable stay in the more competitive Los Angeles market.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sutter Health intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in a lawsuit that accuses the giant Northern California health system of abusing its market power and charging inflated prices, according to a state judge.\u003c/p>\n\u003cp>In a \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\">ruling this week\u003c/a>, San Francisco County Superior Court Judge Curtis E.A. Karnow said Sutter destroyed documents “knowing that the evidence was relevant to antitrust issues. … There is no good explanation for the specific and unusual destruction here.”\u003c/p>\n\u003cp>Karnow cited an internal email by a Sutter employee who said she was “running and hiding” after ordering the records destroyed in 2015. “The most generous interpretation to Sutter is that it was grossly reckless,” the judge wrote in his 12-page ruling.\u003c/p>\n\u003cp>Sutter, which has 24 hospitals and nearly $12 billion in annual revenue, said the destruction was a regrettable mistake.\u003c/p>\n\u003cp>Employers and policymakers across the country are closely watching this legal fight amid growing concern about the financial implications of industry consolidation. Large health systems are gaining market clout and the ability to raise prices by acquiring more hospitals, outpatient surgery centers and physician offices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s stunning what Sutter did to cover up incriminating documents in this case,” said Richard Grossman, the lead plaintiffs’ lawyer representing a class of more than 1,500 employer-funded health plans.\u003c/p>\n\u003cp>In April 2014, a grocery workers’ health plan sued Sutter and alleged it was violating antitrust and unfair competition laws. The plaintiffs began requesting documents related to contracting practices, such as “gag clauses” that prevent patients from seeing negotiated rates and choosing a cheaper provider and “all-or-nothing” terms that require every facility in a health system to be included in insurance networks \u003c/p>\n\u003cp>Sutter disputes the broader allegations in the lawsuit over its market conduct and said its charges are in line with its competitors’.\u003c/p>\n\u003cp>The judge said that in 2015 \u003ca href=\"https://www.youtube.com/watch?v=hLtEtJgW7no\">Melissa Brendt\u003c/a>, Sutter’s chief contracting officer in the managed-care department, and an assistant general counsel, Daniela Almeida, authorized Brendt’s executive assistant to destroy 10 years’ worth of managed-care documents going back to 1995. The company earlier had scheduled the documents to be destroyed in 2035 — 20 years later.\u003c/p>\n\u003cp>The executive assistant, Sina Santagata, testified in a deposition she wasn’t aware of any other time in her 17 years at Sutter when the managed-care department destroyed records held in storage.\u003c/p>\n\u003cp>In his \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/sutter-nov-13-order.pdf\">Nov. 13 ruling\u003c/a> against Sutter, the judge singled out an email by Santagata as “particularly noteworthy.”\u003c/p>\n\u003cp>The executive assistant emailed Brendt, the chief contracting officer, on July 30, 2015, after sending the order to destroy the records. She wrote, “I’ve pushed the button … if someone is in need of a box between 3/15/95 & 11/23/05 … I’m running and hiding. … ‘Fingers crossed’ that I haven’t authorized something the FTC will hunt me down for.”\u003c/p>\n\u003cp>The Federal Trade Commission (FTC) enforces antitrust laws in health care to prevent hospitals, drugmakers and other industry players from engaging in anti-competitive behavior that could harm consumers.\u003c/p>\n\u003cp>Santagata testified that she was being “sarcastic” in her email, and Sutter told the judge that the FTC reference was just a “joke.”\u003c/p>\n\u003cp>Karnow saw no humor in it. “There are infinite topics for jokes, and the choice of this one is strong evidence” in the plaintiffs’ favor, he wrote in his order Monday.\u003c/p>\n\u003cp>As part of his sanctions against Sutter, the judge ordered the health system to examine \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/11/plaintiffs-motion-for-sutter-sanctions.pdf\">email\u003c/a> backup tapes covering 2002 through 2005 to search for documents on some of the same topics as the destroyed records. Also, Karnow said he will consider a plaintiffs’ motion for issuing jury instructions that are adverse to Sutter in light of the document destruction. The trial is scheduled for June 2019.\u003c/p>\n\u003cp>“The record shows that Sutter’s conduct was more than just an inadvertent error,” Karnow wrote.\u003c/p>\n\u003cp>Sutter spokeswoman Karen Garner said the incident was a “mistake made as part of a routine destruction of old paper records” and the Sacramento-based health system disclosed the error as soon as it was discovered.\u003c/p>\n\u003cp>“We regret that as part of a routine archiving process we failed to preserve some boxes of decades-old hard-copy documents,” Garner said.\u003c/p>\n\u003cp>The United Food and Commercial Workers and its Employers Benefit Trust initially filed the case against Sutter in 2014. The joint employer-union health plan represents more than 60,000 employees, dependents and retirees. The court certified the case as a class action in August, allowing hundreds of other employers and self-funded health plans to potentially benefit from the litigation.\u003c/p>\n\u003cp>In addition to its 24 hospitals, Sutter’s nonprofit health system has 35 surgery centers and more than 5,000 physicians in its network. It reported $11.9 billion in revenue last year and income of $554 million.\u003c/p>\n\u003cp>Grossman, the plaintiffs’ counsel, said he welcomed the judge’s ruling. But he said much of the evidence is irreplaceable, particularly handwritten notes from negotiating sessions and meetings involving key Sutter executives.\u003c/p>\n\u003cp>He said those records covered a critical period in the early 2000s when there was a “sea change in Sutter’s contracting strategy” and it implemented provisions that insulated the health system from price competition.\u003c/p>\n\u003cp>“This was groundbreaking in the industry,” Grossman said. “Until we address the anti-competitive behavior of entities like Sutter, we will not solve the problem of high costs in health care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The plaintiffs are seeking to recover hundreds of millions of dollars from Sutter from what it claims are illegally inflated prices. The lawsuit alleges that an overnight hospital stay at Sutter hospitals in San Francisco or Sacramento costs at least 38 percent more than a comparable stay in the more competitive Los Angeles market.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>[contextly_sidebar id=\"71H0Ojb2GH2PmTeKnFMAoSO20SXx8Yvn\"]“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Sutter’s Gleeson says if companies don’t sign the letter, Sutter will ask health insurers to find another way to convince companies to agree to the arbitration terms.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"info": "Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. Download Chris’s Song of the Week plus other highlights from the broadcast. Produced by American Public Media.",
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"rss": "https://feeds.publicradio.org/public_feeds/a-prairie-home-companion-highlights/rss/rss"
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 13
},
"link": "/podcasts/mindshift",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 12
},
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
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"info": "Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.",
"airtime": "SAT 6pm-7pm, SUN 1am-2am",
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},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw",
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"order": 15
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"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
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