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Board hears that Laguna Honda and network gaps push some SFHSS members out of county for skilled nursing
Summary
Blue Shield told the board its Medicare process centers patient/family/provider choice and that 11 of 15 San Francisco skilled nursing facilities are in-network; members and clinicians said Laguna Honda often will not accept Medicare Advantage/commercial patients and urged MOUs or letters of agreement to preserve in-county access.
Representatives from Blue Shield of California (Liz Kanape and Charles Lee) presented findings on skilled nursing facility (SNF) availability and selection. Blue Shield said selection is led by the patient, family and medical team; after a SNF is chosen, the facility coordinates with Blue Shield to obtain authorizations. The carrier reported 15 SNFs in San Francisco as a snapshot from November: 11 contracted…
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