HealthLeaders Media Finance - October 20, 2008 | Readers Write View as a Webpage | Subscribe for Free
Readers Write
Philip Betbeze, Senior Editor-Finance

I'll be back next week to opine, but I've been busy running the finance panel at this year's HealthLeaders Media Top Leadership Teams Annual conference. In the meantime, readers, you have been especially active with your comments lately, and I thought I would take this opportunity to share with the rest of you what your fellow readers have thought about some of the recent columns I have written. [Read More]
  October 20, 2008

Editor's Picks
Nonprofits leave the city for greener pastures
In the "not necessarily news" department, the Wall Street Journal has discovered that nonprofit hospitals have been systematically closing older hospitals in poorer areas of the country and rebuilding in more affluent suburban areas. I know, astounding isn't it? This has been going on for years, and is just another example of what happens when care isn't properly reimbursed. I think if you ask most CFOs, the kind of healthcare system we have in this country that depends on cross-subsidization demands these types of moves. You'll have to be a subscriber to read the entire article, but suffice to say that hospitals and hospital companies, whether they're big or small, can't survive on the reimbursement they get from people who can't pay or for whom the government "subsidizes" their care. It's the old squeeze the balloon on one end and it gets bigger on the other end metaphor. Ascension can't be happy that the story led with them, but being the biggest nonprofit out there, they get a target painted on their backs. To be fair, such hospitals do get tax breaks, but if you were building a new hospital, where would you go? [Read More]
Grassley gets M.D. Anderson's records on charity care
Anyone who thought that a worldwide financial crisis and the fact that his party is no longer in power would slow down Sen. Charles Grassley's efforts to get hospitals to justify their tax exemptions seems to be sorely mistaken. The Iowa senator, who declined interview requests for this story, has been pursuing nonprofit and government hospitals for years, contending that some are woefully negligent in providing charity care equal to the tax exemptions they receive. [Read More]
The financial crisis and healthcare
This is an interesting op-ed piece that argues the recent financial rescue plan for the economy sets a precedent for shooting down what the author sees as red herring arguments that any single-payer healthcare system would be a de-facto socialist takeover of the healthcare system. Not sure I totally agree with his argument, but it's an interesting take on the subject nevertheless. He's right in one respect: the fact that government is now buying equity stakes in banks weakens the argument that healthcare is a sacred cow as it is currently constituted. [Read More]
Finance Forum
Putting Your Resources Where Your Priorities Are
So far in 2008 we have endured turmoil in the credit markets, a sea change in regulations and payments affecting physician-hospital relations, and dare we mention the "R" word? If yours is not one of the growing number of healthcare organizations that has formally integrated its strategic and financial planning processes, now is the time. Beyond arguing for the necessity for integrating strategic and financial planning, Francine Machisko and Scott Clay, senior principals at the Noblis Center for Health Innovation in Atlanta, GA, have come up with a practical approach for achieving the necessary integration. [Read More]
Finance Headlines
Study: Many cancer patients forgoing care because of cost
USA Today - October 13, 2008
Aurora Health Care buys cardiology group
Milwaukee Journal-Sentinel - October 14, 2008
City puts bid in on east New Orleans hospital
New Orleans Times-Picayune - October 14, 2008
St. Francis Health System feuds with Anthem over contracts
Indianapolis Star - October 14, 2008
Independence Blue Cross adding Minute Clinics to network
Philadelphia Business Journal - October 13, 2008
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From HealthLeaders Magazine
Model for Success
Running a medical group has never been more complex. But many practices have found ways to not only survive—but thrive. [Read More]
Money Talk

Cleveland Clinic Health System, Cleveland, OH
Rating: Aa2
Outlook: Stable
Affected Debt: $2 billion
Agency: Moody's Investors Service
Remarks: Upgraded from Aa3 because of the system's ability to continue to improve and sustain very good operating performance and liquidity, combined with very strong fundamentals. [Read More]
Audio Feature

Deep Impact: Today's audio file is my interview with Scott Clay, a senior principal with the Noblis Center for Health Innovation, about the effect of the deepening financial crisis on healthcare organizations, an important issue all of our audience is dealing with in some form. Scott and I talk about access to capital, reimbursement issues and investment challenges associated with the crisis—so take a few minutes to listen. [Listen Now]

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