HealthLeaders Media Finance - July 27, 2009 | Midwestern Town the Anti-McAllen, TX, for Medicare Costs View as a Webpage | Subscribe for Free
Midwestern Town the Anti-McAllen, TX, for Medicare Costs
Michelle Ponte, Senior Editor-Finance

Doctors in McAllen, TX, became part of the growing national furor over rising healthcare costs with a June New Yorker magazine article, pointing out that the area cost the government $15,000 per Medicare beneficiary in 2006. In Winona, MN, Medicare costs are about two-thirds less than those in McAllen, says Mike Allen, CFO of Winona Health. Allen says the HSA is "the anti-McAllen," citing strong coordinated care efforts as one of the primary reasons. [Read More]
  June 27, 2009

Editor's Picks
Minneapolis-based Fairview Health Services, Medica make a deal to cut costs
Some providers aren't waiting for a healthcare reform. One health system and health plan in Minneapolis are reforming healthcare on their own, a move that will impact 300,000 patients. Fairview Health Services and Medica health plan have signed a three-year contract, in which the health system will be paid based on cost control, quality, and clinical outcomes. The arrangement, say officials at both organizations, encourages the clinic to experiment with less costly care such as group and nurse-only visits. [Read More]
Feds find many docs are using ultrasounds too often, possibly fraudulently
A recent OIG report is pointing to possible ultrasound claims fraud by physicians in 20 U.S. counties. King, NY, was the top-spending county, where 35% of Medicare beneficiaries received ultrasounds costing $235 per person as opposed to the rest of the country, which spent $55 per beneficiary. Tip off No. 1 that a claim might be fraudulent? According to the OIG report, not having a prior service claim from the doctor who ordered the scan raises suspicion about whether the doctor ever saw the beneficiary. [Read More]
How much charity care must hospitals give to stay tax-exempt?
Sen. Charles Grassley (R-IA), who has consistently challenged hospitals on their tax-exempt status, says nonprofit hospitals should spend at least 5% of expenses on charity care to keep their tax-exempt status. The only problem with that is it won't work, at least not in Maryland, where hospitals vary widely in the amount of community benefit they provide. For example, hospitals offered anywhere between .05% to 6.33% in charity care, finds a recent report in the journal Health Affairs. Only two Maryland hospitals reported that they contributed more than the 5%, according to the report, which included a representative sample of 20 of Maryland's 45 acute care hospitals. As such, 95% of hospitals in the state could not meet proposed standard. [Read More]
New York-based healthcare union forgoing raises to aid pension
Hospital pensions have hit hard times along with investment portfolios. But, you know it is bad when a healthcare union agrees to give up wage increases. New York's healthcare union agreed to give up $1 billion in wage increases for 145,000 workers to help state hospitals increase pension contributions. The union's fund has lost $3.5 billion in recent years, which meant that 48,000 retirees and thousands of current workers were in jeopardy of receiving reduced pension payments. While this is a good stop-gap measure, there was no word about what hospitals will do moving forward to prevent such losses again. [Read More]
Finance Forum
On the Way to Reform: Medicare Rate Updates Pack the Biggest Punch
The likelihood of national healthcare reform is greater than any time in recent history. Amidst the dizzying array of healthcare reform proposals and revolutionary demonstration projects, HealthLeaders Media guest columnist Scott Clay says we need to be clear about one thing. Over the next three years the financial performance and viability of hospitals and health systems will be more affected by one measure than any other: Medicare inpatient payment rate updates. [Read More]
Finance Headlines
What to do if your CEO gets the ax
Philip Betbeze, for HealthLeaders Media - July 24, 2009
Massachusetts firms pare costs elsewhere to pay for coverage
Wall Street Journal - July 24, 2009
Officials seek assurance on keeping Bucks County, PA, hospital open
Philadelphia Inquirer - July 24, 2009
University of Chicago Medical Center moving forward with plans for hospital pavilion
Chicago Tribune - July 23, 2009
30-Day readmission rates go public, fueling CMS desire for a 'new normal'
Sg2 (free registration required) - July 22, 2009
Red Tape Snarls Billions of Healthcare Dollars
John Commins, for HealthLeaders Media - July 20, 2009
Miami-Dade's financially-strapped public hospital system to ask for more tax money
Miami Herald - July 20, 2009
From HealthLeaders Magazine
Time For 'Dr. Next'?
HealthLeaders July 2009 Generation X and its life-balancing, tech-oriented, team-playing doctors is taking over. But what kind of healthcare will they give us? [Read More]
Service Line Management
Prepare for the Cancer Boom
Aligning the right cancer care team and utilizing the appropriate technology is essential for maintaining a patient-centered service line. [Read More]
Money Talk

A look at one hospital's struggles to improve

Mount Sinai Hospital (NY)
Rating: A2
Outlook: Stable
Affected Debt: $415.4 million
Agency: Moody?s Investors Service
Remarks: Rating upgraded from A3 due to a FY 2008 operating profit of $46.9 million, and a favorable multi-year financial performance despite the challenging New York City market.
[Read More]
Audio Feature

Planning for a Public Health Plan: Georganne Chapin, president and CEO of Hudson Health Plan in New York, says a public health plan is a critical part of healthcare reform, but fears a health insurance exchange will just create another layer of bureaucracy at an enormous cost. [Sponsored by Emdeon] [Listen Now]