What the future will hold for many health-care providers remains unknown, but the Santa Barbara Neighborhood Clinics got a taste of that uncertainty recently when they were forced to lay off staff to stay in the black.
“The entire medical provision industry is in a state of transition,” said Gary Gray, chairman of the board for the Santa Barbara Neighborhood Clinics, regarding the cuts the organization was forced to make. “There’s a great deal of uncertainty as to what comes next.”
Full implementation of the Patient Protection and Affordable Care Act will occur in January 2014, and how community clinics will be affected by a probable influx of new patients remains an open question.
As for this year, Gray said the clinics had anticipated an increased patient load when forming this year’s budget, and had hired accordingly.
But that demand from patients never materialized, he said, and the clinics were forced to cut personnel as a result.
“It was nothing against any individual,” he said. “We laid off very fine people, but we were just overstaffed.”
The organization operates a medical and a dental clinic on Santa Barbara’s Eastside, and medical clinics on the Westside and in Isla Vista.
Gray wouldn’t reveal exactly who was laid off or how much money that saved the clinics in the long run, but he did say that they “eliminated two or three doctors and as well as two or three administrators and their support people.”
“We’re where we need to be right now,” he said, adding that the cuts put the clinic back in the black.
Earlier this month, Dr. Cynder Sinclair, executive director of Santa Barbara Neighborhood Clinics, sat on a health-care panel at Antioch University, and asked Insurance Commissioner Dave Jones what the clinics could do to get ready for January 2014 and about pent-up demand among previously uninsured.
Sinclair quoted numbers from CenCal, saying as many as 25,000 people in Santa Barbara County will be newly eligible for Medi-Cal after ACA is implemented. If 40 percent of those are on the South Coast, “what about pent-up demand?” she asked Jones.
“The real challenge is for physicians to take those patients,” Jones said. “Not only is there a shortage of primary care physicians nationally, but the reimbursements for Medi-Cal are such that it’s difficult to take on those patients. It’s going to be a challenge.”
For now, Gray said, the clinics provide medical care to 17,000 patients on the South Coast, and “will continue to do so.”
Gray said the clinics have seen a modest increase in patients as the state has decreased the amount of Medi-Cal reimbursements per patients that it will pay.
“It’s a push and pull in both directions,” he said.
The clinics are also undertaking a conversion to electronic health records, which has been a complex process, he said.
“Our fear was that if we brought on doctors too late, we wouldn’t be able to get them trained,” he said.
Gray said that he doesn’t anticipate additional cuts, and said the clinics eventually will have to expand their payrolls to deal with fully implementing the Affordable Care Act.
“Our medical practice is very steady, we just missed the target,” he said.