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Blue Shield warns of potential provider shifts as Brown & Toland doctors form Sutter IPA
Summary
Blue Shield told the HSS board Sutter Health informed about 1,500 members on Oct. 1 that 48 Brown & Toland primary-care physicians may leave to form a Sutter IPA effective Dec. 31; Blue Shield said it was not formally notified by the medical group and is assessing remaining capacity and member outreach options.
Sean Levering of Blue Shield provided a network update to the HSS board on potential provider changes affecting HSS members.
Levering said Sutter Health sent letters on Oct. 1 to roughly 1,500 HSS AccessPlus members indicating that Brown & Toland primary-care physicians are expected to leave and form a Sutter IPA effective Dec. 31, 2019. Blue Shield said it had not been formally notified by Brown & Toland and is treating the notice as a change to which it must respond under Department of Managed Health Care requirements. Blue Shield has asked the provider group for current panel capacities and a recruitment/retention plan and said it will report physician counts and outreach options at the next board meeting.
Blue Shield noted that AccessPlus members would likely be able to remain with their physicians if the physicians transition to the new Sutter IPA, but Trio members could have to select new primary-care providers. The board asked for a follow-up report on capacity and the number of affected members and physicians.
