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Kaiser to Open Hospital
Kaiser has decided to open the 106 bed hospital it built in Fremont, California six years ago. Kaiser believes the population of the area now will support two full hospitals. The other one is Washington Hospital. It will not open until next year due to need for staff and equipment. Currently, the lab, x-ray and operating rooms are being used for outpatient services. Top
In Lakeland, Florida the regional Medical Center called the mother of a patient to state her daughter had passed away. The mother drove to the hospital. Upon arrival she found her daughter alive and well. The patient who actually died was a 81 year old male. Since both patients had heart procedures the same day and were on the same ward, a nurse picked up the wrong chart to have the chaplain call the family. The hospital has decided not to bill for the admission and gave the patient a basket of flowers and an apology. Top
KPC Medical Management, the bankrupt IPA, wants to destroy the medical records and x-rays of 20 years worth of patients. This constitutes about 12 million patient files. There are still hundreds of thousands of patients in Southern California who are left without access to there current medical records. There is nothing in the law as to who pays for the forwarding of these records of a bankrupt IPA. So far HMOs have paid for the completion of medical tests and the forwarding of records for about 250,000 of their members at a cost of about $3 million. To date about 21,000 individual requests for records have been received but not answered. The management company states it will charge a small fee to retrieve and forward records and all records not transferred by next June would be destroyed. What happened to the Knox-Keene Act, Medicare , Medicaid and malpractice that state records should be kept for a statutory period of time. Top
A large group of internists employed by St. Francis Medical Center have bolted and moved to a rival hospital, UPMC health Systems. They state that they will give up their privileges at St. Francis and apply for them at the three UPMC institutions. The physicians state the move to the larger and more stable system was due to cost cuts at St. Francis and UPMC has research capabilities. Want to bet money had something to do with it? The president of the St. Francis System appealed to the St. Francis employees to change physicians in order to remain with the system. She also asserted the doctors were abandoning their fellow professionals and called the departure troubling. Maybe she ought to look inside the system to prevent future defections. Top
No Private Patients for San Francisco General
San Francisco General has begun to turn away private, Medicare and Medicaid patients in order to focus on their mission of treating the uninsured. The hospital is in dire financial straits and are turning away these patients since the reimbursements are low and requirements for patient care are high, including the cost to process the insurance claims. The physicians are now paid 20% below the national average in a city that has the highest cost of living in the country. Top
In the past thirty years there have been about five owners of this Ojai community hospital. Now there is a sixth. The community itself bought the facility by forming a nonprofit corporation and is obtaining $2.5 million in loans. The closest hospital is 30 miles away in Ventura. The hospital is actually making a slight profit.
Long Beach Community Hospital is also opened under the auspices of the City of Long Beach. It had been closed by CHW. The city raised $15 million by a coalition of physicians and volunteers. The new hospital will be smaller than the one closed but will offer basic medical services. It will not offer neonatal intensive care or cardiac surgery. Top
Florida Blue Cross Deselection
Blue Cross and Blue Shield of Florida has terminated about 120 physicians in the state including about 70 in the central Florida area. This deselection is not making the Florida Medical Assn. into happy campers. They are filing a complaint with the insurance office about the firing of a physician in central Florida. This physician has filed a law suit against the Blues for the deselection, as was reported in my last publication. The Blues state that some of the physicians dropped have been given an opportunity to appeal. They should all be given that opportunity. The Potvin case in California stands for the proposition that if an insurance company controls a significant amount of your practice the physician is to be given the procedural due process of notice and a hearing. Top
Dr. Corlin, the incoming AMA president, in his inaugural speech called for more funding to track gun related homicides, suicides and other related incidents. Some of the delegates are questioning the wisdom of the AMA taking a stand on this controversial issue. It is unusual since the conservative AMA usually never backs anything. Top
Nassau University Medical Center has fired 24 union physicians. The financially strapped Center is projected to run out of money in 2003. The union representing the physicians will go to court to obtain an injunction against the firings. Top
A contract dispute between Redwood Regional Oncology Center and St. Joseph Health Foundation is going to cost patients or their insurers more money. The patients will have to pay usual and customary rates to the newly non-contracted physicians. The Health Plan of the Redwoods will increase their payments to the physicians for "continued care." New Foundation patients will need to go to Marin County or San Francisco for care, unless they wish to pay out of pocket. The physicians asked originally for a 15% increase and then reduced it to the walk away number of 10%. Isn't belonging to an HMO wonderful? Top
Several physicians in Boca Raton, Florida have thought of a
new gimmick. They currently have a 3000 patient load. They are
willing to reduce that to 600 and promise same day or next day visits, annual physicals,
nutritional counseling and coordination of care with specialists if the patient
pays a fee of $1500 plus their usual insurance rates. This may be legal
under Medicare since they state the cost is for a routine physical exam, a
non-covered item.
600 x $1500 = $900,000, not bad. Top
The Associated Press reports that Americans went to the ED 102 million times in 1999, up 14% from 1990. The Center for Disease Control stated that the country's aging and overall growth explained the added burden. Of course the population only grew 7% in the same period. They forgot managed care that made patients wait for weeks to see a provider. Top
North Carolina's state employees plan is planning to cut physician payments by 2% for primary care and 30% for radiologists and pathologists. These cuts are not negotiable. The plan had previously cut payments to hospitals. The plan is funded by the legislature. The plan expects a drop out rate of no more than 7%. Those hit the hardest by the cut can not drop out since they are bound by contract to take care of all hospital patients. Top
Intermountain (IHC) lost 15 Ogden, Utah physicians in a fee
dispute. This has curtailed significantly the ability of people to obtain
medical care via the organization. There is only one orthopedic surgeon
and one neurosurgeon left in the plan. Now 46 businesses have entered into
the fray with large ads backing the Intermountain position. The physicians
wanted a 38% fee increase, according to IHC. This IHC states is ruinous to
the plan. The employers have not requested a meeting with the physicians
to hear their side but are only told that their fees will go up
dramatically.
The paper the next day reported on a meeting the night prior when the physicians
retaliated by showing IHC executives received a 30% increase in pay last year
for taking no risks. The doctors also pointed out that since 1992 their fees had
been reduced
102%.
Top
Guide Ranks CA Medicare + Choice Plans
A guide put out by the Consumer's Union stated that Kaiser was the best value for the money. They warned that this does not mean the best quality since Kaiser is only rated average for overall satisfaction and below average in ease of referrals. The article warned consumers not to believe that the most expensive plans were the best. Kaiser was about 1/2 the cost of the lowest rated plan, PacifiCare/Secure Horizon's Basic Plan. Top
A group of Phoenix Orthopedic Surgeons have got it. They like others in California and elsewhere are putting up their own office building with attached ambulatory surgical center, physical therapy, x-ray unit with all amenities, and DME. This type arrangement will make the lives of the physicians much easier and provide for smoother care for their patients. Have your physicians considered this? They should. Top
Cleveland University Hospital Systems have begun to play hard ball. They are now requiring all vendors that want to do business with them to offer the University's health plan. This does not have to be exclusive but it must be offered with no greater cost, expense or burden than those of another health care organization. Top
Blue Cross will institute a policy for paying more money to those groups and physicians who provide better care. The details of the policy will be announced next month. The question is how a plan can measure the quality factors necessary to make decisions or is it all going to be on saving money for the plan. Hill Physicians of San Ramon, California is looking forward to the program. The CEO stated that his organization continues to grow, up 12% in revenues in the past year. They have also received bonuses from several programs over the past year.
Hill is also the largest IPA in California. It has 2400 physicians and their net revenues climbed 12% with net operating income up 35%. Their capitation payments were also up 13% to $267 million. Top
I have never mentioned medical software in this newsletter before. My change is due to an article in the June 29, 2001 Wall Street Journal. The article is the most glowing report I have ever read on medical technology. The software is called UpToDate. It comes in a CD-Rom and on a website. The CD-Rom is updated every four months and is touted to be exceedingly user friendly with finding answers in only several clicks. It costs $495 for the first year and $395 from then on. However, if one can simply find answers to questions it is well worth it. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.