It’s a hard time for healthcare.
H.R. 1, President Trump’s “big beautiful bill,” brings massive cuts to Medi-Cal. Hospitals face nursing and other workforce shortages. Doctors grapple with reductions in reimbursement.
In that setting, health system CEOs, doctors, nurses, housing leaders and others gathered outdoors on Sept. 17 at the Ronald Reagan Presidential Library & Museum in Simi Valley for a “State of Healthcare Summit.” The first-time event was organized by the Moorpark Chamber of Commerce and the Ventura County Medical Association that advocates for doctors and patients.
Dr. Felix Nuñez, CEO of the Gold Coast Health Plan that administers Medi-Cal in Ventura County, described H.R. 1 as a “laser-guided missile” designed to push people off
of Medicaid programs across the nation.
Many of its provisions, including work-reporting rules and more frequent eligibility checks, kick in on Jan. 1. The changes and cuts will likely reduce Ventura County’s Medi-Cal population by 15,000 people next year, Nuñez said. Fear and uncertainty about what's coming has already played a role in causing some 20,000 people to drop out of the program or not to re-enroll in the last year.
Doug Kleam, president of St. John’s hospitals in Oxnard and Camarillo, said the changes will mean more uninsured people will hold off getting healthcare treatment until they have no choice. Then they’ll seek care in emergency rooms, filling up the facilities.
The effects will be widespread, said Dr. Ryan Shanahan, an emergency room physician and board president of the Ventura County Medical Association.
"It's just going to be harder to keep the doors open," he said.
In a night marked by optimism, healthcare leaders talked about efforts to raise awareness about new Medi-Cal requirements and other changes. Dr. Gagan Pawar, CEO of Clinicas del Camino Real, said the clinic system is using an AI tool to identify patients who qualify for Medi-Cal but may not know it.
Nuñez talked of the importance of healthcare organizations and others working together.
“The only way we get through this is collaboration,” he said.
Several leaders talked about ways to bolster the healthcare workforce, citing efforts at Moorpark College and California Lutheran University to make students more aware of different career paths. Phil Buttell, CEO of Los Robles Health System, said the organization spent about $5 million to help Pepperdine University launch a nursing school.
It means more potential employees are training at the Thousand Oaks hospital but other barriers remain, like the median home price in Ventura County of more than $900,000.
“Not many of them have an opportunity to stay,” Buttell said of the students.
Kleam said his health system is exploring ways to build onsite housing for healthcare workers training at St. John’s. Linda Braunschweiger, CEO of Housing Trust Fund Ventura County, cited the importance of entities in and outside of healthcare working together.
“If we do it in silos, nothing really changes,” she said.
Austin Purkeypile, president of Adventist Health Simi Valley, said reductions in insurance reimbursement are making it hard for doctors to survive.
“The private practice model is completely failing,” he said. Purkeypile called on hospitals to share the same specialists, rather than building exclusive networks of doctors.
One of the strengths of healthcare in the region is that hospitals already help each other out, said Danielle Gabele, CEO of Ventura County Medical Center. The Ventura hospital plays its part by operating the only pediatric hospital and pediatric intensive care unit in the county.
In a program billed as problem-solving, Ventura County Medical Association Executive Director Brian Barry tossed out another idea that has attracted attention across the state. Maybe funding for California’s planned high-speed rail should be diverted to bolstering healthcare, he said, pointing at the billions spent on the transportation project "with nothing to show for it."
Buttell of Los Robles emphasized the magnitude of the challenges facing healthcare.
“We have to rethink everything,” he said.
Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com.
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This article originally appeared on Ventura County Star: 'Rethink everything:' Local health leaders take pulse of challenges
