HealthLeaders Media Finance - August 18, 2008 | Dick Scruggs, the Bell Tolls for Thee View as a Webpage | Subscribe for Free
Dick Scruggs, the Bell Tolls for Thee
Philip Betbeze, Senior Editor-Finance

How things have changed in less than four years. Especially for celebrated plaintiff's attorney Richard "Dickie" Scruggs. You hospital CFOs remember him, don't you? He came after you aggressively just four short years ago for your charity care policies, your chargemaster prices, and your own aggressive collection practices. Now he's in jail. [Read More]
  August 18, 2008

Editor's Picks
Do safety-net hospitals put money over mission?
The Center for Studying Health System Change says some safety-net hospitals could be engendering their mission to serve the poor by developing “centers of emphasis” and building satellite facilities in the suburbs. My take: They should do just about whatever they can to supplement the poor reimbursement they receive from government sources in order to continue their mission to serve the poor. Dozens of these hospitals have closed in the past several years precisely because they haven't thought ahead about what low reimbursement will mean to their long-term viability. Without margin, there is no mission. [Read More]
Some walk-in clinics closing after boom
Growth in walk-in clinics is slowing after an initial boom, but don't be fooled. This is a minor consolidation in an industry that has seen wildcat growth in recent years. That growth has simply outstripped demand for services and has caused physician extender salaries to skyrocket. It seems that co-locating the clinics in drugstores has been a winning strategy, and early standalone clinics seem to be the first to be closed in the recent mini-trend. The strong players will survive and continue to take market share away from primary care physician practices in the process. [Read More]
Lawsuit claims Pittsburgh doctors paid kickbacks by device companies
Six medical device companies have been accused by a competitor of paying kickbacks to several doctors in the Pittsburgh area in order to limit competition. The suit claims that the six companies paid illegal kickbacks from 1988-2007 in return for physician agreements to use their products, which include hip joints, knees, shoulder implants, and other orthopedic and surgical products. Perhaps this is the first of many of these types of lawsuits we'll see in coming years in an industry that seems rife with the kind of corruption we once saw in the drug business. [Read More]
GM to crack down on dependent healthcare coverage
Guess it takes a near-bankruptcy for GM to start doing what it should have been doing all along with hourly worker healthcare benefits. It's cracking down on employees who are collecting healthcare benefits for dependents if they are not eligible for such coverage. The company is giving hourly workers until Aug. 20 to voluntarily remove ineligible dependents from health coverage after which employees will have to prove family members are eligible. GM pays nearly $5 billion a year in healthcare costs for its employees. [Read More]
HHS sees 2011 ICD-10 implementation
The Department of Health and Human Services has proposed replacing the ICD-9-CM code sets now used to report healthcare diagnoses and inpatient procedures with the more advanced ICD-10-CM code set currently used in other nations. Nearly 30 years old, ICD-9-CM will run out of possible code combinations by next year, however, under the proposal, the new code sets will not be implemented until Oct. 1, 2011. What's wrong with this picture? [Read More]
Finance Forum
Memo to the new CFO: Focus on the ED
The new hospital CFO typically has so many challenges to address, it's difficult to know where to focus energy first. HealthLeaders Media contributor Caral Edelberg has some advice for new CFOs that can not only provide some early successes, but which can also give the new CFO a big picture idea of how much to expect from future improvement initiatives. [Read More]
Finance Headlines
Money for some Maryland hospitals staves off collapse
Washington Post - August 13, 2008
Dallas County commissioners set Parkland bond election
Dallas Morning News - August 12, 2008
Healthcare costs seen rising 10% in 2009
AP/Yahoo! News - August 11, 2008
Atlanta children's hospital begins expansion
Atlanta Journal-Constitution - August 14, 2008
Illinois board rejects hospital's plans to build in Plainfield
Chicago Tribune - August 13, 2008
Illinois panel backs Advocate purchase of Libertyville hospital
Chicago Tribune - August 12, 2008
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From HealthLeaders Magazine
Help the Uninsured (Without Going Broke)
HealthLeaders August 2008 The number of people who can't pay much—or anything—for their care just keeps rising. Some hospitals have found new ways to help them while still protecting the financial health of the hospital. [Read More]
Money Talk

Lake Forest Hospital, Chicago, IL
Rating: A-
Outlook: Positive
Affected Debt: $73.7 million
Agency: Standard & Poor's
Remarks: Outlook revised from stable reflects more consistent financial performance and strong debt service coverage as well as a strengthened balance sheet. [Read More]
Audio Feature

Preparing for the RAC: This week, I spoke with Michael Taylor, MD, about the CMS Recovery Audit Contractor demonstration project. Though the RAC program has yet to be rolled out nationwide, it's coming soon, and hospitals will need to know how best to respond to an audit's findings. Since the limited demonstration project began, Taylor, senior Medical Director of Governmental Retrospective Appeals at Executive Health Resources near Philadelphia, has helped hospitals file more than 7,000 appeals of RAC findings. Of the 1,000 appeals that have been fully adjudicated thus far, all have been overturned. With a nationwide rollout coming by 2010, hospitals should prepare to challenge audit results ahead of time. [Listen Now]