KINGSBURG – Valley Health Team has entered into an agreement with Tri-County Health Care District to offer an after-hours urgent care at its current facility and has just bought property in the Business Park to open an even larger health facility.
VHT CEO Soyla Reyna-Griffin shared details of the agreement during a March 5 a Health Care District town hall meeting.
VHT is headquartered in San Joaquin and already operates 11 health center sites. In 2014, VHT applied for a grant through the Health Resources Services Administration (HRSA) of the federal government to open a health care facility in Kingsburg. They offer primary medical care at their current site in the northwest portion of the building where Crestwood Behavioral Health operates at 1250 Smith St.
Now, they offer urgent care there and will build a new medical facility in the Business Park in 18 months.
After-hours care is available from 5-9 p.m. Monday through Friday, and 11 a.m. to 5 p.m. Saturday. Walk-in services are available for health needs as sprains/strains, upper-respiratory infections, urinary tract infections, minor lacerations, allergies, asthma exacerbations, ear infections, sore throat, viral illness such as the flu, skin rashes and others.
“Within 15 minutes of opening, we had our first three patients. We’re very excited about that,” Reyna-Griffin said. “We’ve purchased property by Sonic and we’ll be building a 15,000 square foot facility offering primary medical care, optometry, behavioral health and dental. It’ll be our biggest health center to date.”
The new site will be at 1905 Morgan Dr., Kingsburg, and will be located on a 1.67 acre plot.
At the March 5 meeting, Reyna-Griffin touted VHT’s quality of care and patient experience program, tailored after UCLA Medical Center’s program and took questions from audience members.
“We here because we want to be here and we want to help the community, like we do in all the other communities across Fresno County,” she said of their other centers.
The agreement calls on Tri-County Health Care District to pay for the costs of operating the after-hours care and the District is giving VHT a six-month’s advance. In their proposed budget, VHT shows it will cost an estimated $513,949 to operate the after-hours service.
Since Tri-County’s budget comes from taxpayers that live in its District, resident Betsy Tunnell had questions about how they’d handle any debt that may result if patients have no insurance.
Reyna-Griffin said fees for those without insurance will be based on their ability to pay. There will also be a prompt pay option where patients would pay $75 in advance.
Health Care District Board President Arlie Rogers said the District would offset the costs when the uninsured are treated there during the urgent care hours.
Tunnell said she disagreed with that decision.
“I object to that. As a taxpayer, I didn’t know we were getting in to this to subsidize health care.”
She also disagreed with the District’s agreement to pay Valley Health Team in advance.
“Valley Health Team is not taking on any risks with this added service. I object to that. I object to the pre-payment of funds and believe if the agreement should continue it should be renegotiated to reflect a monthly reimbursement with limitations on costs.”
Reyna-Griffin said some of their sites show a loss while others show a profit, but added that’s common in the health care industry. She said since they are a federally qualified health center, they receive a different rate of compensation from Medical than private doctors and actually make more when a patient with Medical visits their facilities.
“If we’re seeing more private insurance here in Kingsburg than we’re seeing elsewhere, we’re not going to make as much money. We will have a loss because of the cost of care. Usually for a private insurance visit, you can make anywhere from $70 to $80 per visit. If it were a Medical visit, you’d make a lot more. We’re probably losing more money in our Kingsburg Center than we are in our Clovis Health Center. There, 85 percent are on Medical and we receive a higher rate [of payment] when we see them.”
Reyna-Griffin said the revenue from their other health centers will help cover the costs and the rates they charge are determined annually. They also look at what other nearby health facilities are charging to ensure their rates are equitable, she said.
Funding also comes from foundation grants, she said.
“We have to be efficient in how we deliver health services and we compete for grants from foundations that provide us dollars to start a new service. We’re not in the business of making money. We’re in the business of providing access. Any reserves we have, we put back into patient care and the communities.”
Their largest source of funds is from the Health Resources Services Administration, Reyna-Griffin said.
“One of the grants we have now is for a residency program through the State of California. One of the grants, they paid 80 percent up front. It all depends on the funders and what they want to do or what’s negotiated.”
Since this is the first time VHT will offer after-hours urgent care in Kingsburg, Reyna-Griffin said the potential for a profit or a loss depends on the mix of patients being seen.
“It all depends on if the acceptance is here at the community level and they embrace Valley Health Team. If they have an urgent need, that they come and utilize our services. You don’t want our providers sitting there doing nothing. It’s utilizing the resources we have to minimize loss to the district.”
Reyna-Griffin added that they make financial reports to HRSA regarding costs and that typically they’re below the average in the state and the nation.
“Our fees are based on relative-based value units. They want you to do that to show your true costs. Another method we choose is by the market. We look at what United Health Centers or Adventist is charging to see if we’re within market, and that’s what we’ll charge. Sometimes, we’re below, so it all depends.”
Rogers explained that Tri-County Health’s agreement is to pay for the cost to have medical providers, regardless of how many patients are seen.
“If they saw 10 patients in one night, the cost to us is the same if they saw no patients that night. If five patients couldn’t pay and five patients could, our cost is just for the provider that’s there, not for how many patients they saw.
Theresa Lipschitz also asked whether the facility would be available for all residents in the Tri-County District, if those with insurance would be charged a higher fee and if it’s the same staff working the day shift as the night.
Since they receive federal funding, Reyna-Griffin said their health centers are open to everyone. They are in the process of adding more insurance companies that will accept them.
“We provide the same services whether you’re on Medical, uninsured or have private insurance. You get the same quality of care, regardless of who you are and your ability to pay.”
Also, it’s a different staff providing after-hours urgent care so as they’re not working 12-hour shifts.
Lipschitz said while she too has doubts about the funding mechanism, she’s hopeful.
“I just hope it works. Right now, I have doubts.”
Reyna-Griffin said since they had three patients within 15 minutes of opening, that indicates the need for the after-hours care. She’s also hoping that in time, residents learn through a positive experience that the financial investment was worthwhile.
“We really care about the patients’ experience. We work hard to ensure our providers provide passionate care and we work with our providers and staff,” she said. “We want you to believe you’ve picked the right partner. We’re very transparent because if I don’t have your trust, I have nothing.”
As far as their new site at the Business Park, Reyna-Griffin said they’ve gone out to bid for a contractor and are making minor adjustments to make it more patient centered.
“We’re expecting to open in 18 months so we’re also scheduling the ground breaking. We have a project in Firebaugh we’re building at the same time.”