The Healthcare Association of Southern California appoints a committee each year to negotiate with the County. The physicians sign a similar Master Agreement. The single contract simplifies administration, and the County also reduces paperwork by contracting with a fiscal intermediary to process claims. The MSI program cuts costs because the county can protect itself through a fixed allocation of dollars to the Master Agreement. Additionally, every hospital with a 24-hour emergency room must treat anyone who shows up in critical condition, or the hospital will lose its license.
Orange County runs the entire program with a staff of seven employees.
This payment covers an average of all five acuity levels, including all nursing, administration, hotel, and ancillary services. The only item excluded is physician charges. Without Universal's help, the Northwest Texas Healthcare System faced a difficult time due to increased competition. The results would have been an increase in taxes, cut in services to indigents, or both. The county decided to exit the business of operating a hospital and focus instead on meeting the needs of the disadvantaged.