Lauren Bacall vamps in the cardiology unit. Laurel and Hardy mug in the radiology wing. Groucho Marx stretches his hands in greeting in the lobby.
The characters are not the cast of a vintage movie, but are featured in black-and-white posters that lend a distinctive touch to facilities operated by the Motion Picture and Television Fund.
Since the beginning of the decade the 77-year-old not-for-profit organization has transformed itself from little more than a bucolic hospital and assisted-living facility tucked away in the recesses of the San Fernando Valley to a steadily growing regional healthcare network.
The MPTF owns a 218-bed inpatient hospital and retirement facility called Motion Picture and Television Fund Hospital and Residential Services. It has a state-of-the-art Alzheimer's unit, which was endowed by Kirk Douglas.
The system also operates a skilled-nursing facility and seven outpatient clinics, including Toluca Lake (Calif.) Health Center; and it affiliates with a 450-physician medical group and employs more than 20 full-time doctors. The MPTF's inroads into managed care include a PPO and contracts with Blue Cross to provide managed-care products through a "private label" HMO.
The scope of care provided by the organization is a far cry from what was envisioned in 1921, when Charlie Chaplin and Mary Pickford established a general relief fund for indigent actors. The move toward providing health services didn't begin until the 1940s, when the hospital was constructed on vast tracts of rolling farmland.
"Their growth has been steady during the past decade, and it's due to better times for the film industry," said Frank Matricardi, a principal with Manhattan Beach-based Phoenix Healthcare Consulting.
Although aerospace and other high-tech ventures tanked in Southern California during the 1990s, entertainment took off, becoming one of the major economic engines in the Los Angeles area. The actors and directors who provide tabloid fodder are supported by a massive and growing infrastructure of lawyers, set designers, computer animators, clerical workers and technicians who need healthcare coverage.
Although the MPTF would not release its revenue figures, William Haug, its chief executive officer and president, projected it will spend $85 million this year on healthcare services, compared with $75 million in 1997. Its charitable arm raises another $15 million a year to provide care for about 93,000 entertainment industry employees.
The MPTF's eligibility is based on work in film, television, radio, cable, stage or studio-operated theme parks. Members of unions affiliated with the entertainment industry make up the bulk of the MPTF's enrollment, but thousands of unemployed members of the entertainment industry receive care at the outpatient clinics.
The system is a rarity in its orientation toward a particular industry.
"It used to just be that Hollywood was in Hollywood. Now it's all over (Southern California), and we're always grappling with the issue of providing services, either through the creation of our own product or getting it from an outside source," said Haug, who is also chairman of the influential Healthcare Association of Southern California hospital lobby.
Haug was recruited by the MPTF a decade ago. Most of the changes toward systemized healthcare delivery have occurred during his tenure.
The MPTF projects it will treat about 90,000 outpatients in 1998, almost double the number treated in 1996. Nearly 70% of its revenues come from outpatient care vs. 75% from inpatient care a decade ago. Payers are the Industry Advantage Health Fund, the MPTF's PPO product and the private-label HMO from Blue Cross.
While most Southern California firms encourage employees to choose HMOs, the entertainment industry has been loath to drop its more lavish benefits. Most MPTF participants receive their care through the PPO, which was created in 1992 and has about 40,000 enrollees. The HMO was created in 1995 but has fewer than 10,000 members, half the projected enrollment.
"People won't give up their choices easily," said David Tillman, M.D., CEO of Industry Advantage Health System, a division of the MPTF. But the MPTF has made managed-care-style tweaks by boosting preventive care and holding health-related seminars for its members.
"One of the most significant things they offer are wellness benefits," said Pamm Fair, associate executive director of the American Federation of Television and Radio Artists, whose 14,000 members can see its own physicians or use MPTF's network. "They used to give us a $500 (annual) wellness benefit. Now it's $1,500, which is like a raise for all of us," Fair said.
"MPTF is like everyone else-looking to control costs while maintaining quality," Matricardi said.
In the meantime, the MPTF is expected to continue expansion. It is contemplating adding more units to its retirement and assisted-living facilities. The retirement facility has a seven-year waiting list.
It may also begin offering services outside Los Angeles, particularly in Orlando, Fla., and New York, which have become secondary hubs for television production.
"We have not ignored the fact we need to expand outside our original geographical boundaries," Haug said.