By LEONARD GRAY / L’Observateur / June 12, 1999

LAPLACE – Ochsner Health Care announced its pullout from River Parishes Hospital in LaPlace, effective June 30, and is apparently slow in certifying physicians at St. Charles Parish Hospital in Luling.Dr. David St. Germain, an internal medicine specialist at RPH, labeled thecancellation of Ochsner’s contract with the hospital “a bait-and-switch.”He added it appears Ochsner had over-extended itself in forming alliances in the River Parishes, found they were losing money and was cutting its losses.

Sean Roussel, marketing director of RPH, observed of the contract cancellation, “I hate when that happens.”Roussel continued that Ochsner’s planning on this was “either not well thought out or they bit off more than they can handle.”He added, “We do plan an advertising campaign soon to give people the alternatives.”Ochsner spokeswoman Connie Baer commented: “We tried to renegotiate rates, but we still have the door open to River Parishes Hospital.”Dr. St. Germain recalled that he and the rest of the River Parish MedicalAlliance signed a two-year contract with Ochsner back on January 1998.

“The prices for services were fixed and set.”After 15 months, or March 1999, the doctors were informed by Ochsner they wanted to change the contract terms as of June 30 by reducing payments sharply.

“We made every effort to talk about a reasonable price, but they chose to terminate the contract early,” St. Germain said, adding he’s heard Ochsnerhas been “going around saying we were overcharging.”St. Germain declared, “That’s absolutely ridiculous!”Baer, speaking for Ochsner, clarified the contract was originally effective July 1, 1997, with an automatic renewal clause each year unless one of the parties elected to withdraw. It renewed in 1998 and Ochsner exercisedits option in 1999. “Nothing was intentionally done to mislead,” she said,adding no one from Ochsner is making any statements about RPH overcharging.

St. Germain said Ochsner came into the community, sold policies to manylarge and small businesses for their employees and used the hospital and physicians as a selling point, then decided to yank the contract six months early. “I think it’s unethical,” he commented. “Here’s the problem withmanaged-care plans – you go for big contracts with low premiums, but the only way you can make it work is with low utilization.”Instead, he said, patients here made use of the service at a higher rate than anticipated and Ochsner now wants to pull out.

Letters have already gone out from RPH physicians to their patients. Dr.Dominic Arcuri, in his letters, stated: “I am writing to inform you that I will no longer be a participating physician provider with the Ochsner Health Plan (OHP) after June 30, 1999. OHP terminated the agreementswith me, other River Parishes area physicians, and River Parishes Hospital by giving us 120 days’ notice. Although we have made numerous attempts,we have been unable to reach an agreement extending the contracts with OHP.”Arcuri later added: “OHP was not willing to work with the local River Parishes area physicians and River Parishes Hospital on an agreement that makes sense for both parties.”He included a list of current health plans in which he is a member, and suggested patients who have other health plans inform him and he would contract with them.

Baer insisted that Ochsner is in the process of contracting with individual RPH physicians, independently of the hospital and commented, “Hopefully, this will be a temporary situation.”Jerry Desselle, marketing director at St. Charles Parish Hospital, said forthe past six months Ochsner had been supposedly trying to certify every physician at the facility but is “taking forever” to accomplish that.

Meanwhile, Ochsner has been selling the policies to major employment groups with the understanding most primary-care physicians at the Luling hospital could be used under the Ochsner plan, including the St. CharlesSchool Board.

However, Desselle noted, few have been certified – only five out of 29, according to the latest updated chart.

“It’s a long and tedious process,” Baer said, adding any physician may contact them to learn where they are in that process. “We do not want ourmembers unhappy.”In December 1998 both hospitals received notice from United Health Care’s Medicare supplement program, effective March 1, when the hospitals refused an offer to reduce their repayments by 20 percent.

In reaction, the hospitals scrambled to help patients find new Medicare supplement plans, or risk losing these steady, long-term outpatient customers to other physicians and hospitals.

That departure left hundreds of senior citizens searching for a new health plan and concerned about whether they would be able to keep their accustomed primary-care doctors.

Now, many local residents with the Ochsner Health Plan are doing the same.

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