HealthLeaders Media Finance - July 7, 2008 | Unfair Competition, Part 2 View as a Webpage | Subscribe for Free
Unfair Competition, Part 2
Philip Betbeze, Senior Editor-Finance

As two Virginia non-profit health systems propose new or replacement facilities that are closer to their regions' insured populations, a high-profile dispute between them calls into question a possible "unbalanced situation." [Read More]
  July 7, 2008

Editor's Picks
Kennedy leads new universal healthcare effort
Sen. Ted Kennedy (D-MA) is apparently working as the front man for a new universal healthcare effort ahead of a presidential election that may hand control of the presidency as well as Congress to the Democrats. Specifics are hard to come by, but Kennedy is working to develop a plan that would at least have a chance of some bipartisan support. Kennedy's office is gearing up for a quick consideration of whatever package he and his team come up with to take advantage of momentum should the Democratic nominee, Barack Obama, prevail over John McCain in November. Massachusetts' state program, which requires people to carry health insurance and has been beset by huge cost overruns, may be a model for a national plan. [Read More]
California sues Prime Healthcare over balance-billing practice
This hospital chain just can't stay out of the newspapers-well, at least they can't stay out of the Los Angeles Times. This time their beef is with the California state Department of Managed Health Care, which has sued the chain for billing patients directly for the balance of their hospital bills that the chain says the patient's insurance company didn't pay. Prime says it's on solid legal ground with the process, and that the state, essentially, has got the wrong guy. If insurers would pay the amount agreed to in contracts, they say, they wouldn't have to bill patients. Legally, Prime may be right, but my guess is that patients are just easier targets than insurers in a fight that's about much more than just what's rightfully theirs. Prime typically cancels all health insurance contracts when it acquires a hospital, says the Times, meaning many of the patients treated in its emergency rooms or who are admitted for longer stays are "out of network," allowing Prime to charge higher fees for their care. [Read More]
Budget problems shelve south Florida teaching hospital
Boca Raton Community Hospital may have to take a charge of at least $20 million to shelve plans to develop a teaching hospital in partnership with Florida Atlantic University and the University of Miami after its finances were too shaky to continue with the project. Officials were forced to write down $50 million in development costs for the facility, but hope to recover as much as $30 million in the sale of the land that was acquired for the project. The hospital expects to take two years to recover from a fiscal year that saw $40 million in operating losses. [Read More]
Bush administration delaying Medicare fee cut
Congress passes laws that it doesn't want to abide by, and then tries to pass laws annually that override the law they passed earlier. Your head swimming yet? Mine is. I guess our Congressional leaders are no different than the rest of us who want to live beyond our means, but this annual Medicare physician fee cut thing takes the cake. Now the president gets in on the act, saying he'll freeze the pay cuts too. This is called painting yourself into a corner. It happens every year with the Alternative Minimum Tax fix, as well. All of these outcomes were easily predictable when these two laws were passed, but they passed anyway. That's called passing the buck. [Read More]
Finance Forum
The Financial Case For a Transitional Care Unit
Few things in the delivery of healthcare services have been so obfuscated by uncertain health policy, regulation, and reimbursement as have Medicare-certified hospital-based skilled nursing facilities. Hospitals that sought to operate units, mandated by Congress as an entitled benefit of the nation's elders, have been frustrated in their mission and denied the opportunity to serve the common health. But consultant Matt McGillick says hospitals can use a transitional care unit to achieve the same purpose at greater profitability. [Read More]
Finance Headlines
Forgers defrauded patients at New England Baptist
Boston Globe - July 2, 2008
Oakland children's hospital lays off 84
San Francisco Chronicle - July 2, 2008
Medicare proposes payment changes for imaging, dialysis
Reuters - June 30, 2008
Massachusetts' pioneering health plan turns 1
USA Today - June 29, 2008
Providence Health to buy California hospital from Tenet
Los Angeles Times - July 1, 2008
Baptist Health System sells remaining interest in Birmingham's Trinity Medical Center
AP/Yahoo News - April 29, 2008
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From HealthLeaders Magazine
Weaning Your Hospital Off of Medicare
HealthLeaders June 2008 A flood of baby boomers, reimbursement cuts, and increasingly ineffective cost-shifting solutions. How can your hospital maintain its level of service and its margin? It's time to get creative. [Read More]
Money Talk

A look at one hospital's struggles to improve

University of Alabama Hospital, Birmingham, AL
Rating: A1
Outlook: Stable
Affected Debt: $220 million
Agency: Moody's Investors Service
Remarks: Outlook raised to stable from negative because of growth in operating cash flow to improve debt coverage ratios.
[Read More]
Audio Feature

Steve Blades, president of the Cardiovascular Outpatient Center Alliance, says his membership is concerned about proposed Medicare reimbursement changes that he says will force the closure of many outpatient cardiac cath labs and result in long wait times for Medicare beneficiaries. Under proposed changes from CMS, reimbursement for cardiac catheterization procedures performed in non-hospital outpatient labs would be reduced 47% by 2010, meaning non-hospital cath labs would receive reimbursements several hundred dollars below the cost of performing the procedure. [Listen Now]

July 14, 2008: Service Line Strategies Workshop 2008: Neurosciences
On Demand: Physician Alignment Strategies: Choose the Right On-call Compensation Model for Your Hospital
On Demand: Marketing your physician practice: A guide to growth
On Demand: Supply Chain Success: Physician Preference Can Save Money and Improve Outcomes