HealthLeaders Media Finance - January 12, 2009 | You Write, I Listen View as a Webpage | Subscribe for Free
You Write, I Listen
Philip Betbeze, Senior Editor-Finance

You readers have been especially prolific lately. I've wanted to share your thoughts with everyone else for some time now, but I've been running off at the mouth myself so much lately with predictions for the new year and recaps of the one just past that I haven't had the space. But that all changes this week. [Read More]

  January 12, 2009

Editor's Picks
Credit crunch derails sale of HCA hospital
At our HealthLeaders Media's Top Leadership Teams event last October, where Al Stubblefield was a speaker, I heard that this deal was likely to fall through if things didn't improve in the credit markets. You know things are bad when Baptist, one of the most creditworthy and well-run hospital systems you'll find, can't make the numbers work for an acquisition like this. HCA took advantage of language in the deal, which already had regulatory approval, to back out if financing wasn't arranged by the end of the year. [Read More]
Kaiser's Cleveland Clinic-only plan didn't work out for hospital, insurer
At one time, Kaiser Permanente and Cleveland Clinic thought an exclusive deal to send patients to the Clinic only among Cleveland hospitals would benefit both parties. Thanks to declining population and a glut of beds in the Cleveland market, as well as patients' reluctance to go downtown exclusively for medical care, the deal didn't work out for either party. It's an example of what's happening in many cities with declining population as hospitals struggle to compete for a declining patient base. [Read More]
Atlanta's Grady gets earful on free care limits
So-called healthcare advocates attacked a plan by Grady Hospital administration that would increase medical costs to some uninsured patients, thwarting a finance board from even discussing the proposal. What this means is that a segment of the population potentially gets better healthcare than those who actually foot their bill. I'm not saying their care shouldn't be subsidized, but at a hospital that's millions of dollars in debt from as far back as the eye can see, this plan, outlined in the article, certainly seems like a proposal that has some merit. No word in the story about taxpayer advocates' point of view. [Read More]
Finance Forum
Weather the Crisis with Creative Cost Control
While many hospitals have long operated with slim margins and careful expense management, today's worldwide financial crisis raises the pressures to unprecedented levels. But the biggest impact may stem from debt financing bonds, which require that certain performance targets be met. Decreases in revenues and increases in costs may call into play these debt covenant ratios and trigger potentially draconian measures by bondholders to assure financial viability. [Read More]
Finance Headlines
Spending growth for healthcare and prescription drugs slows
New York Times - January 5, 2009
Tufts, Blue Cross negotiations break down
Boston Globe - January 7, 2009
Georgia hospital bailout approved
Atlanta Journal-Constitution - January 6, 2009
Baltimore Washington Medical Center doubles size, expands scope
Baltimore Sun - January 4, 2009
Economy hitting Pennsylvania hospitals
Philadelphia Inquirer - January 7, 2009
Seven New York hospitals accused of $50 million Medicaid fraud
New York Times - January 6, 2009
Louisiana hospitals will get financial lifeline
New Orleans Times-Picayune - January 7, 2009
Crozer Keystone Health System eliminates 400 jobs
Philadelphia Inquirer - January 8, 2009
From HealthLeaders Magazine
20 People Who Make Healthcare Better
HealthLeaders August 2008 In our annual HealthLeaders 20, we offer profiles of individuals who are making a difference in today's complex healthcare world. [Read More]
Service Line Management
Here Come the Seniors
The well-documented influx of baby boomer patients promises to increase the already high demand for senior services. But the prospect of expanding a service line that relies so heavily on Medicare has some hospital leaders jittery. [Read More]
Money Talk

Baylor College of Medicine, Houston, TX
Rating: Aa2
Outlook: Not applicable
Affected Debt: $140 million
Agency: Moody's Investor's Service
Remarks: Upgraded from Baa1 in conjunction with the organization's conversion of the bonds' interest rate mode from auction-rate to daily rate and the provision of a letter of credit from Wachovia Bank. [Read More]
Audio Feature

Reeling in the Revenue: During the Top Leadership Teams conference in October, I spoke with Jerry Miller, MD, president of Holston Medical Group in East Tennessee, about how his 70-physician multi-specialty practice convenes each year to strategize on investments the practice needs to make in strategic initiatives to diversify the practice's revenue streams.
Sponsor HealthLeaders Media Finance

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February 12: Incentive-Based Compensation Plans to Enhance Physician Performance
On Demand: What Your Practice Is Worth: Calculating Fair Market Value
On Demand: Financial Meltdown: Managing Through the Crisis
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