HealthLeaders Media Finance - January 19, 2009 | On Rain . . . and Dumb Sayings That Ring True View as a Webpage | Subscribe for Free
On Rain . . . and Dumb Sayings That Ring True
Philip Betbeze, Senior Editor-Finance

When it rains, it pours, and that's never been as true financially as it is in this recessed economy. Healthcare used to be called recession-resistant, even recession-proof. Those days are long gone. Denials, RAC audits, slow payers, no-payers, and other challenges are affecting healthcare much more swiftly and deeply than they used to. [Read More]

  January 19, 2009

Editor's Picks
United Health settles suit over systemic underpayment
New York Attorney General Andrew Cuomo announced a settlement on Tuesday with UnitedHealth Group, one of the nation's largest insurers, which will require an overhaul of the databases used to determine out-of-network medical bill payments nationwide. The settlement resulted from a year-long investigation into what Cuomo's office called a scheme to defraud consumers by underpaying patients by hundreds of millions of dollars over the last decade. This is the culmination of years of work by hospitals convinced that the Ingenix database developed by United systematically and unfairly denies compensation, I wrote about this about a year and a half ago when relatively tiny Medisys Health Network and CEO David Rosen told me, "It's lonely out there being the only guy throwing stones." Since then he's been joined by a multitude of others fighting the Ingenix and UnitedHealth system. How lonely is it now, David? [Read More]
MA Blue Cross sets sights on lower healthcare costs through contract
Blue Cross Blue Shield of Massachusetts has signed an innovative contract with a hospital and two physicians groups that will slow the rate of medical cost increases while rewarding top-performing doctors with bigger paychecks. The insurer thinks the new contracting format will cut increases in healthcare costs over time by reducing treatment and providing better quality care. What's not clear is whether the new contract idea will have strong uptake with influential providers or—a bigger concern going forward to me—whether the "restricting care" portion of the contract will come under scrutiny from influential consumer groups. I smell lawsuits. [Read More]
Two Queens hospitals likely to close soon
The bad economy and its concomitant pressure on state budgets appear ready to claim two hospitals in Queens, NY. St. Johns Queens and Mary Immaculate hospitals, owned by Caritas and with 400 beds, a trauma center, and 3,000 employees between them, have been kept afloat through $44 million in loans and grants over the past two years, but the state appears unwilling or unable to further assist the two hospitals. Long Island Jewish Medical Center, a financially sound suitor for the two hospitals, has offered to take them over but only if it can combine them into a single site, which would need a bond issue and further state support. Here's hoping that support can be secured before the hospitals face a likely February closure. [Read More]
Finance Forum
Love The Ones You're With
The economic climate creates a circumstance to look at what you have with new-found affection and care. Properly applied to people, technology, and facilities, this mindset should increase productivity. When I talk about loving the ones you're with, I'm talking about the machines and the buildings, but most of all, I'm talking about the people. [Read More]
Finance Headlines
California hospitals feel ill effects of recession
Los Angeles Times - January 14, 2009
Wheaton Franciscan Healthcare-Iowa to cut 80 jobs
Chicago Tribune - January 14, 2009
Walgreen broadens its healthcare reach
Wall Street Journal (subscription required) - January 14, 2009
Surgeon shortage pushes hospitals to hire temps
Wall Street Journal (subscription required) - January 13, 2009
HealthSouth to expand hospitals in 2009
Birmingham Business Journal - January 12, 2009
Cost at heart of healthcare debate
Orlando Sentinel - January 12, 2009
University of Chicago hospital to trim 7% of budget
Chicago Tribune - January 10, 2009
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From HealthLeaders Magazine
Flat-World Healthcare
HealthLeaders August 2008 Globalization is no longer an uncertain trend in the distant future. U.S. providers must refine their organizational strategy to compete in a marketplace that is broader than ever before. [Read More]
Service Line Management
A Spinal Shift
As minimally invasive procedures consume a larger portion of spinal care, provider organizations have many opportunities—and challenges—in an increasingly outpatient service line. [Read More]
Money Talk

Doctors Community Hospital, Lanham, MD
Rating: Baa3
Outlook: Negative
Affected Debt: $139 million
Agency: Moody's Investors Service
Remarks: Downgraded from Baa2 and outlook revised to negative based on the organization's weakened liquidity position compared with the 2007 fiscal year. [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.
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