HealthLeaders Media Finance - November 10, 2008 | Just Not Good Enough View as a Webpage | Subscribe for Free
Just Not Good Enough
Philip Betbeze, Senior Editor-Finance

If you can momentarily turn off the noise about the financial crisis gripping this country, perhaps you can hear whispers from hospital senior leaders about community benefit. We've heard recently from Sen. Charles Grassley that he's not stepping back on his crusade for greater transparency among hospitals and the amount of community benefit they do (or do not) provide their communities in return for the tax benefits they get. Meanwhile, one CFO at an event I recently attended said the hospital is a community benefit just because it's there. Sorry bud, but that's not good enough. [Read More]
  November 10, 2008

Editor's Picks
Dallas County voters OK $747 million for new Parkland hospital
All right, I'll start off with the disclaimer that I don't pay taxes in Dallas County. That said, however, I visited this 1954-era facility back in September when the race for the bond issue was at full steam. And I couldn't think of a better use of taxpayer money than this facility. So-called "charity" hospitals are on a massive downswing over the past several years—cuts in reimbursement have hurt them badly, they have one arm tied behind their backs already as the hospital of last resort, and, let's be honest, many are mismanaged into deep financial holes. But not this place. Its whole mission—considering Parkland offers everything from routine wellness care at community clinics to complicated burn treatment at the main hospital—is reducing the cost of care. It's proven it deserves the community's investment in a new hospital, and I'm glad voters agreed. [Read More]
CMS delays RAC permanent program
Don't get too excited after reading that headline. Despite the fact that CMS has delayed the implementation of the permanent program, it's still likely to go forward, according to this report from my colleague Dom Nicastro in The RAC Report, which is owned by HCPro Inc., the parent company of HealthLeaders Media. The delay likely stems from a protest by a contractor that was not among those selected to work in the permanent program, and not a change in direction for CMS regarding the implementation of the program itself. Joseph Zebrowitz, MD, executive vice president of Executive Health Resources in Newtown Square, PA, says the permanent program will not change. [Read More]
Court blocks White House push on Medicare expenses
A federal court has blocked the Bush administration's attempts to save money on Medicare by paying for only the least expensive treatments for certain conditions. The judge in the case said the move wasn't permitted under Medicare law. While I'm all in favor of doctors choosing the most clinically effective treatment for their patients, certainly CMS needs to have some discretion. Clearly this was a ham-handed attempt to curtail expenses, but I think equally as clearly, the law needs to be changed. Perhaps I'm not smart enough to determine how to do this most effectively, but doctors, as a group, have not performed admirably in the area of choosing cost-effective treatments for their patients. Study after study has shown they—as a group—are unduly influenced by drug and medical device companies' marketing efforts at least as much as they are influenced by efficacy evidence. [Read More]
Finance Forum
Weathering the Financial Storm
Everyone is feeling the pinch of the ailing economy, as the stock market continues its freefall, the government bails out financial institutions, and the credit market remains frozen. Meanwhile, the government is tightening reimbursement regulations and seemingly trying to take back money it has already paid hospitals. What can hospitals do to weather this financial storm? The obvious answer is anything that will improve the bottom line. [Read More]
Finance Headlines
Lance Poulsen of National Century Financial Enterprises convicted
Los Angeles Times - November 3, 2008
University of Iowa Hospitals to cut $25 million
Des Moines Register - October 31, 2008
Children's hospital bonds approved in California
Sacramento Bee - November 5, 2008
Merger of Kentucky-based St. Elizabeth and St. Luke finished
Cincinnati Enquirer - November 4, 2008
Tenet swings to 3Q profit on investment sales gain
Associated Press - November 4, 2008
Wisconsin-based Columbia St. Mary's cuts 74 jobs
Milwaukee Journal-Sentinel - November 4, 2008
HealthSouth raises outlook; profit falls in third quarter
Wall Street Journal (subscription required) - November 5, 2008
West Penn Allegheny Health System posts $93.9 million operating loss
Pittsburgh Business Times - November 4, 2008
Gallatin, TN-based Sumner Regional Medical Center plans 90 layoffs
The Tennessean - November 4, 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

Roger Williams Hospital, Providence, RI
Rating: BB
Outlook: Stable
Affected Debt: $16.3 million
Agency: Standard & Poor's
Remarks: Outlook revised to stable from positive due to light cash position of 41 days and close to break-even financial position through 2007 and the first nine months of 2008. [Read More]
Audio Feature

Costs of the Credit Deep Freeze: I got the opportunity to speak with Al Stubblefield, CEO of the Baptist Health Care Corporation, at HealthLeaders Media's Top Leadership Teams event in Chicago. We spoke about the freeze in the credit markets and how that's affecting hospitals' expansion and M&A plans for the coming year and beyond. [Listen Now]

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December 9, 2008: Grow Outpatient Revenues Now: 3 Impact Strategies
On Demand: Financial Meltdown: Managing Through The Crisis
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