Agreement helps some patients, but Lovelace-Christus still without contract
Bruce Krasnow | The New Mexican
Posted: Wednesday, September 08, 2010
- 9/9/10
     
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At 88, Roxanne Redlish really likes her primary-care doctor and doesn't want someone new.

Yet because of the dispute between Lovelace Health Plan and Christus Health Systems, she has not been able to see Dr. Kristine Parke of Rodeo Family Medicine, one of the primary-care medical practices owned by Christus St. Vincent Regional Medical Center.

Redlish moved to Santa Fe some 16 years ago to be near her daughter, a Pojoaque veterinarian. She's on oxygen 24 hours a day, homebound, and loves Parke, who has an office at 4401 Rodeo Road, near Sam's Club and not far from her home.

"I'm 88 years old and my doctor is very important to me, and I haven't been able to see her. She's been very helpful in seeing that I get the additional help that I need," said Redlish, who has a half-day caregiver who drives her to appointments.

Redlish said Lovelace sent her a new insurance ID card with the name of another primary-care doctor, but she couldn't bear to make an appointment. "When you're my age, to change doctors is difficult," she said.

For years, Lovelace has had provider agreements with what was the locally owned nonprofit St. Vincent Hospital. This is the first new contract since St. Vincent merged with Christus Health System, a faith-based nonprofit that operates 50 hospitals and 350 facilities in eight states and Mexico. Lovelace was purchased in 2001 by Ardent Health Services, a private company based in Nashville, Tenn. The insurer operates four hospitals in Albuquerque and has 200,000 insured patients in New Mexico — 14,000 of them in Santa Fe.

Negotiations between the health care companies broke down last month and since Aug. 21, there has been no contract between them for services and reimbursements — except for emergency care and patients who were already hospitalized at Christus.

There is now an agreement in place that that allows patients with ongoing conditions to continue using Christus physicians and affiliates such as Rodeo Family Health. Lovelace has served some 290 patients under the agreement, according to Laurie Volkin, Lovelace spokeswoman.

Redlish got a call from Parke's office Tuesday to set an appointment for this morning. "That was the most information I got," she said.

The agreement covers a variety of services, including radiation oncology, chemotherapy, some previously scheduled office visits and patients on a course of treatment up to 90 days.

Meanwhile, both sides continue to talk about the master contract that would set reimbursement rates for Lovelace patients. Lovelace plan members not under the agreement still need to seek treatment at non-Christus offices and go elsewhere, such as Española or Albuquerque, for elective hospital care.

"We're still trying to work out the broader issue," said Christus spokesman Arturo Delgado.

"I can see my own doctor. That is what's important to me," Redlish said Wednesday. "She called and made arrangements, so I'm going in."

Lovelace continues to maintain its customer-service hot line from 8 a.m. to 5 p.m. seven days a week to answer any patient questions. That phone number is 1-877-727-3050.

Contact Bruce Krasnow at brucek@sfnewmexican.com





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