HealthLeaders Media Finance - December 1, 2008 | Parkland Redux View as a Webpage | Subscribe for Free
Parkland Redux

Philip Betbeze, Senior Editor-Finance

Back in July, I was skeptical that Parkland Health System in Dallas could convince local voters to increase their tax bill to fund a $747 million portion of the cost of a new hospital in a bad economy. Boy was I wrong. [Read More]
  December 1, 2008

Editor's Picks
Monument to healthcare's excess soon to rise in Manhattan?
Developers in Manhattan are pitching a 60-story glass-and-steel tower on the island's West Side as an international showcase and permanent conference center for the healthcare industry. Supporters envision the building as a permanent exhibition center for hundreds of vendors to the medical industry, from hospital food and furniture suppliers to pharmaceutical companies and makers of X-ray machines and surgical devices, according to the article. Call me a cynic, but as the article describes it, I envision the building as a permanent version of the nauseating temporary booths vendors try to outdo each other with at the big healthcare trade shows—most of which are simply expensive tributes to excess. Perhaps they could add some penthouse apartments to house those ubiquitous "booth babes?" [Read More]
Health insurers offer to insure all applicants, with one condition
This argument by health insurers seems as clear as can be. If we want health insurers to accept all applicants regardless of pre-existing conditions, we should require all Americans to have some sort of health insurance. Doing so in an enforceable manner, as we do with auto insurance in most states, would ensure that millions of those uninsured by choice no longer have the option of free-riding at others' expense, and would presumably help pay for care for those who require much more care than they could ever pay in premiums. The devil is in the details, as always, but given the political capital that the new Obama administration has in spades as well as the national mood to do something to aggressively change the distorted healthcare system, a proposal with these broad considerations should be enacted as soon as possible. Plus, their plan agrees on many points with Obama's Health and Human Services nominee Tom Daschle. [Read More]
UPMC's risky drive for revenue
This article is a good case study of what can happen on the dark side of tax-exempt nonprofits that behave more and more like for-profit corporations. It details how an effort by UPMC to bolster its liver transplant program may have been corrupted, but more importantly, takes the time and effort to understand why a major nonprofit hospital operator might be incented to sacrifice patient care in the name of growing a lucrative business. I wouldn't be surprised if after this article, UPMC CEO Jeffrey Romoff gets invited to talk with Sen. Charles Grassley. That would be an interview that he would not be able to turn down, as he did the Wall Street Journal's reporter for this story. [Read More]
State urged to review fees for elite Massachusetts hospitals
Market clout does have its benefits—even in healthcare. In a world where healthcare providers are told over and over again that employers and the government want reimbursement to be predicated on quality measures, it seems that the ability to cobble together a group of healthcare facilities that dominate market share is at least as important. It is in Massachusetts, anyway, where a group of hospital representatives is asking the state to review how Massachusetts General Hospital, Brigham and Women's Hospital, Children's Hospital, and a few other institutions are able to obtain higher payments from health insurers even though they can often not demonstrate any difference in the quality of the care delivered by those hospitals. Such a review seems appropriate, given that such payment disparities are a disincentive to hospitals that are pursuing an agenda based on quality and safety based on the belief that doing so will not only do right by patients but improve their financial standing. [Read More]
Finance Forum
Increasing Early Patient Payments Starts with a Change in Mindset
Hospitals and physicians interested in collecting patient payments earlier in the patient care process ought to know two very important things before providing service: how much to charge and whom to charge. Guest columnist Jorge Wong says while this demand may be challenging, it is also a unique opportunity for providers to better communicate with patients and increase their point-of-service collections. [Read More]
Finance Headlines
Moody's reports question healthcare's ability to weather recession
Chicago Tribune - November 20, 2008
Kansas City's St. Luke's Health System to cut 61 jobs
Kansas City Star - November 19, 2008
Deductibles march higher for employer-provided health insurance
Los Angeles Times - November 20, 2008
Hunter out, Wiebking in as Provena Health CEO
Chicago Tribune - November 20, 2008
Clarian Health hospital merger approved
Indianapolis Star - November 21, 2008
Hartford Hospital, UConn Health Center propose merger
Hartford Courant - November 21, 2008
Studies: Private Medicare plans have added costs for little gain
New York Times - November 23, 2008
Long Island hospital teeters on brink of bankruptcy
New York Times - November 20, 2008
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From HealthLeaders Magazine
What's Your Brand?
That's what your patients want to know. But hospitals are discovering the same old differentiators aren't good enough anymore. Is YOUR organization ready to deliver on its brand promise? [Read More]
Money Talk

Baptist Health System, Knoxville, TN
Rating: A1
Outlook: Negative
Affected Debt: $135 million
Agency: Moody's Investors Service
Remarks: Upgraded from Baa2 based solely on amendments to the legal documents by which Catholic Healthcare Partners has assumed the system's obligations. [Read More]
Audio Feature

Device Dysfunctionality: Today we're talking with John Bardis, chairman, president and CEO of MedAssets, one of the nation's largest healthcare supply chain and revenue cycle companies, about a variety of issues facing healthcare, not the least of which is the cost equation, which is unsustainable long term. Bardis talks about the dysfunctional economy, his challenges in running a now-public company, and the institutionalized lack of transparency in medical device pricing, which he believes leads to irrational high costs in healthcare. [Listen Now]

December 16: What Your Practice Is Worth: Calculating Fair Market Value
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