HealthLeaders Media Finance - July 21, 2008 | CMS: We Pay Dead People View as a Webpage | Subscribe for Free
CMS: We Pay Dead People
Philip Betbeze, Senior Editor-Finance

An investigation found that CMS paid nearly 500,000 claims to medical equipment providers who submitted fraudulent bills in the names of dead patients. Maybe it's time Medicare officials started regularly checking monthly death reports from Social Security. [Read More]
  July 21, 2008

Editor's Picks
Hospitals not immune to inflation
The cost of medical supplies used in hospitals is on a precipitous rise. No, I'm not talking about the complex and opaque pricing behind such sophisticated items as artificial hips and pacemakers, but rather, ordinary everyday items like gloves, plastic bed pans, blood bags, syringes and tubing-all of which rely on petroleum to produce. In some cases, these items have nearly doubled in price since last year, putting the hurt to hospitals' bottom lines. [Read More]
Doctor-clinic ties in St. Louis area questioned
The Stark law and anti-kickback legislation appear to work well keeping down costs for ancillaries like imaging. If the provider does not take patients in federal programs, the federal law does not apply. And in such cases, the docs who have a stake in referral revenue are ordering CT and MRI scans up to 50% more often than their colleagues who don't have that financial interest. As much as physicians-as a group-want to play the card that their decisions are above reproach, in this case, the numbers don't lie. And is anyone surprised? Must be nice to be in a business where you control both demand and supply. The folks at OPEC would love to have as good a deal. [Read More]
Chicago's Evanston Northwestern acquires rival hospital
Previous Federal Trade Commission troubles certainly haven't dampened Chicago's Evanston Northwestern Healthcare's acquisition jones. ENH will pay $160 million to get a deal done to acquire Rush North Shore Medical Center in Skokie. The FTC, which reached a deal with ENH recently over its challenge of ENH's early-decade acquisition of Highland Park Hospital, has not yet asked for additional information about the merger terms, usually a first step in any investigation over anticompetitive behavior. [Read More]
Online derivative monitoring system supports risk management
This column might be of interest to you if you use derivatives to finance your hospital or health system. Despite the self-promotion, the article describes how counterparties to your debt may be required to furnish collateral in case of a trigger event, but is under no obligation to tell you about such an event. That's why an automated online tracking system is important for borrowers to track their varied derivative positions. [Read More]
Deal may be near on embattled Atlanta hospital CEO's pay
Officials with Atlanta safety net hospital Grady Memorial believe a separation deal is imminent with current CEO Pam Stephenson, whom they accuse of having orchestrated a sweetheart interim CEO deal that pays her more than $600,000 a year and includes a $750,000 severance package-a severance package included despite the fact that she was hired as an interim CEO. The hospital is expected to name a new CEO as early as today. Once they put the Stephenson era behind them, maybe this important hospital can finally get the fresh start it needs. [Read More]
Finance Forum
Implications of severity-graded DRGs for service line structure, Part I
The introduction of severity-graded DRGs complicates the use of service line structures. The changes are meant to better tie Medicare payments to hospital costs and more accurately reflect the severity of illness; however, they also bring with them the need for reorganization of healthcare infrastructures that had been based on the old charge-based DRGs. In Part I of this article, the authors examine the current use and challenges service line structures face in today's healthcare systems. Part II, which discusses how to improve quality of service and patient care by restructuring service lines in response to the new cost-based DRG system, will run in next week's edition of HealthLeaders Media Finance. [Read More]
Finance Headlines
Congress easily overrides president's veto on doctor pay
Washington Post - July 15, 2008
Confrontation between doctors and insurers heats up
Dallas Morning News - July 13, 2008
Businesses balking at proposed charges related to Massachusetts healthcare law
Boston Globe - July 15, 2008
Vanderbilt program to teach doctors, nurses business skills
The Tennessean - July 15, 2008
Patients curb prescription spending
Wall Street Journal (subscription required) - July 16, 2008
Repeat 'super-users' swamp hospitals' ERs
Newark Star-Ledger - July 13, 2008
Some health centers working with doctors' part-time desires
Detroit Free Press - July 14, 2008
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From HealthLeaders Magazine
The Hospital of the Future
HealthLeaders July 2008 Sure, your organization offers sophisticated, compassionate care. But the patients of tomorrow will want much more than that. Here's how some hospitals are creating facilities for a new vision of healthcare. [Read More]
Money Talk

A look at one hospital's struggles to improve

Hallmark Health System, Boston
Rating: BBB
Outlook: Stable
Affected Debt: $63.9 million
Agency: Standard & Poor's
Remarks: Outlook revised to stable from positive thanks to financial performance that did not meet expectations, and continued losses from operations year-to-date. [Read More]
Audio Feature

Convenient Care Clinics and Stand-alone ERs: A Threat to Doctors?: There are opinions aplenty about whether so-called "drugstore clinics" and stand-alone emergency rooms are a significant threat to traditional physician practices. Paul Breslin, a senior principal at the Noblis Center for Health Innovation, works in strategy, clinical service business planning, and master facility planning assistance for healthcare organizations ranging from community hospitals to academic medical centers and physician practices. Paul spoke with me recently about the strategic implications of the proliferation of convenient care clinics and stand-alone emergency rooms to physicians and physician practices. [Listen Now]

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