August 1, 2004 News



Money Issues


Tenet has officially sold their Redding, California Hospital to Hospital Partners of America for $55 million.  The fire sale price was to get rid of the headaches of Medicare exclusion if they kept it. 

California's Sutter Solano Hospital has been cited for terrible patient care in their anesthesia department.  The DHS states that this represents an immediate harm for patients.  Sutter Solano has responded by correcting the unsupervised anesthesia and paperwork.  The hospital said that it was missing paperwork but that makes no sense.  The state doesn't give out the quick fix or your out sentence for paper work problems.  The Joint has also made a special inspection due to leadership problems and the report is due soon.   

In a man bite dog story, York Hospital in Maine has taken out an advertisement in the local paper supporting a physician on their staff who was found guilty in a med mal case.  The ad states that a med mal panel that reviewed the case found no deviation from the standard of care.  The case was a brain hemorrhage post clot busing medication by an emergency room physician.  The case will be appealed if it's not overturned by the judge. Kudos to York Hospital for backing a staff physician! 

Central Montgomery Medical Center in Lansdale, Pennsylvania, is promising all patients will be seen by a nurse within fifteen minutes of registration or the visit is free for the the hospital ED bill.  They want the patient in the ED and not in the waiting room where the condition may change during the wait.  There are other hospitals around the country that use the same marketing tactic. 

I did not know what section to put this in, so its here.  Garden Hospital in Palm Beach, Florida, is being sued by about 110 patients for Staph infections.  Now, the Palm Beach Post reports that the hospital was fined by the state $323,800 in 2003 for ignoring infection control procedures, improperly storing meds, and failing to alert health officials when patients returned to surgery for post op infections.  The hospital negotiated a reduction in the fine to only $95,000.  This information was public record but not released to the press. The hospital has lost alot of patients after it was investigated by the state and feds for their filth.  The hospital, a Tenet facility, also fired their CEO and COO. 

In Portland, Oregon a group of physicians have purchased a defunct hospital and are renovating it.  there will be no ED but there will be an urgent care center.  There will be surgery and a 40 bed mental health department.

In Seattle, Washington, the CEO of Swedish Medical Center are in the midst of a non confidence vote regarding the CEO.  The CEO is bringing in hospital based physicians in lieu of using staff physicians.  This is the largest hospital in the city.  The vote will be tallied on August 4 and the results sent to the Board to decide the next step. The vote may affect a proposed merger with another hospital. 

Healthgrades, Inc. a company in Colorado has come out with the statistics that about 195,000 people die each year due to hospital error.  The based their report on Medicare data.  They looked at how many patient safety incidents occurred and then how many died as a cause from the incidents.          Top


In Illinois, as the malpractice war heats up, a count of the physician licensed in the state are 9000 more than a decade ago.  There is also an increase in the count of the high risk specialists.  This does not differentiate those physicians that remained fully licensed but have cut back on their high risk procedures, such as OB.  It also doesn't say where these physicians practice.  As an example, I have an Illinois license from decades ago but it is inactive since I have not practiced there since 1970.  Am I counted as one of the Illinois physicians?  I don't know.

The St. Louis Post Dispatch states that in Alton, Illinois, one Ed physician and three specialists are leaving the area.  This will cost the area half of their ENT and OBs.  

An article in the Albany Business Times describes the difficulty in recruiting OBs to the community.  The reason is the malpractice climate.  The great news is that instead of an expected 22% increase in premiums, the New York insurance commissioner only allowed a 7% increase. 

The Kansas City Business Journal reports that a problem is the right data in med mal is not available.  The trial attorneys say there is no data to support the claim that physicians are leaving Missouri.  In the past 10 years there has been an increase of about 1000 physicians in the state.  I don't know how many more or less people live in the state in the same time period.  The other problem is that retired physicians keep their licenses, so the actual number of physicians practicing is unknown. 

In Cincinnati, a hospital physician group has started their own malpractice company.  The physicians will fully own the company and the company and will be a "captive".  The company will be located in the Caymans to reduce start-up costs.  It will be administered by another company from Georgia.  The company is only available to Christ Hospital physicians for now.        Top

Money Issues

Medicaid pay is forcing physicians from seeing patients.  From 1998 to 2003, there was a 27% increase in fees but there was a 41% fee increase for primary care.  This left 10% for OB and 11% for other services.  Those other services are the specialists who are dropping out of the program.  This limits any referrals from the primary care physicians.  The other problem is the bureaucracy of the system.  This probably is costing the system as many physicians as the small pay.

The San Francisco Business Journal reports that Blue Cross HMO has paid out $57 million in bonuses in 2003.  The money was for good scorecards.  

Kaiser is planning to raise rates 11% in Hawaii beginning January.  This would make a 24% premium increase in two years.  Last year the state insurance commissioner cut the requested 14.5% increase to 11.7%.  Kaiser just approved a pay increase of 23% over five years for their union employees.  

Kaiser also reported its first six months net income was up 37% to $832 million.  Their operating margin for the first two quarters was 5.4%.  This is a huge margin.

HMOs are continuing their decline for the third year in the People's Republic of Massachusetts.  This is good news for the people of the state who want choice and thought.  It may not be many.  

The VA system is attempting to get more money for its physicians in order to keep them from private practice. Instead they should be dismantling the system that is duplicative of the healthcare system of the rest of the country. 

Maybe, I'm not so wrong.  The Senate Veterans' Affairs Committee has passed a bill requiring Medicare eligible veterans to choose yearly between the VA system and Medicare.  They could purchase drugs via either program.  An amendment allowing the vet to continue VA care if they selected Medicare was defeated.

Blue Cross of Tennessee has changed its payment methodology causing a drop in payments to physicians.  They are taking Medicare payments and adding a percentage above it.  For a group of neurosurgeons in Nashville that amounts to an 18% decrease in payments.  Blue Cross says that their feedback has been positive.  The Tennessee Medical Association states the opposite.  The program is supposed to be revenue neutral for the insurer and most physicians should not see more than a 4% spread from the new system.  This system is not unique to Tennessee and is used by other insurers and in other states.  Some of the major players in the high risk surgery fields are not happy.  Blue Cross says this was done at the behest of physicians and that they will meet with any physician who is not satisfied.  From a legal standpoint, unless all the contracts renewed on July 1, when the change took effect, I do not understand the potential breach of contract.          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.