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St. Joseph foundation to relaunch practice

PRIMARY CARE ASSOCIATES TO DISSOLVE BETWEEN ST. JOE, SUTTER’S FOUNDATION AND OTHERS

SONOMA COUNTY – St. Joseph Health’s medical foundation will operate its first Sonoma County practice in more than six years, taking half of a longstanding medical group – Primary Care Associates, which will dissolve on Oct. 1.

“We’ve done pretty well for some time now and even invested half a million in electronic health records, but the problem has been we have gradually shrunk, largely because a number have chosen to leave the community or to go to [Kaiser] Permanente Medical Group,” said Dr. Bo Greaves, president of Primary Care Associates.

The practice that once represented more than 54 doctors in 11 offices at its height in 1998 has shrunk to less than 15 doctors this year, when the group entered discussions to link with a larger practice.

“At that time we realized we really needed to join forces if we wanted a chance of strategically building a system to help community-based primary care survive,” Dr. Greaves said. Established in 1994 from the consolidation of four independent primary care offices, PCA will officially break up Oct. 1 when the group’s remaining four offices end their partnership. A fifth Rohnert Park location consolidated with a Santa Rosa office earlier this year.

PCA’s two largest offices will split between the county’s public hospital foundations – Sutter Medical Foundation North Bay and a professional corporation newly created by St. Joseph Health’s Heritage Health Care Foundation.

The Primary Care Associates pediatrics’ office in Santa Rosa will become the Annadel Medical Group next month, forming a professional services arrangement with Heritage, which works with an affiliated network of more than 1,600 physicians in Los Angeles and Orange counties. The Sonoma County office will be St. Joe’s first attempt to branch out of southern California in several years. A similar agreement, also with PCA, ended early in 2002 after five years in operation.

“We’ve been really successful with the model so far in Orange. It’s proved to be the most effective model for delivering care with the best patient outcomes,” said C.R. Burke, president and chief executive officer of Heritage Health Care Foundation.

The pediatric doctors will stay in the same office and little other than the banner on the building will change. Mr. Burke said the foundation does plan to add more doctors, but it does not have a specific goal. Former Sonoma Valley Hospital administrator Lucy Weiger will serve as director of the medical practice.

For PCA’s other large office, the five primary care doctors, including Dr. Greaves and four nurse practitioners, will join Sutter Medical Foundation North Bay, bringing the foundation’s total to more than 60 doctors either signed or in the pipeline.

Sutter Medical Foundation North Bay Executive Director Chris Rogers said the group plans to add another 50 doctors during the next four years, including a recently opened Lake County branch it hopes will have at least 20 providers.

“[PCA] is a really important group in the county, and we are excited about having them join the foundation,” Mr. Rogers said.

The primary care patients also will not notice much change other than the sign on the building, but the group will no longer accept Blue Shield CalPERS HMO plans for the publicly employed. Also, patients from the Sutter group will be funneled into Sutter Medical Center of Santa Rosa, and St. Joe foundation patients will go to Santa Rosa Memorial Hospital.

The Sutter Foundation currently has 14 locations, but it will soon consolidate six specialty offices into its Landmark office behind Kohl’s off Highway 101.

“We want to keep the primary care doctors dispersed in the community so patients can access them more easily and they retain that smaller office feel, but we can have a greater economy of scale by putting all of our specialties in one place,” Mr. Rogers said.

One of PCA’s remaining two smaller offices has already severed from the group, joining Northern California Medical Associates on Aug. 1. The final two-doctor office will break up, with one physician joining Kaiser, and the other staying in an independent practice.

“Our hope is that we can continue to offer the community an alternative to Kaiser. It’s a great system and a lot of people really love it, but it’s not for everyone, and it’s important that people have a choice,” Dr. Greaves said.