Healthcare Finance

Citing rising costs from uninsured and underinsured patients, analysts say bad debt will continue to undercut hospitals' profits in the coming year, and there's no relief in sight. "[T]he uninsured and underinsured population is growing faster than hospitals can boost admissions or raise prices to insurers," said Robert Hawkins, an analyst with Stifel Nicolaus & Co. in Baltimore. The issue of uninsured and underinsured patients is a wide-ranging problem with no simple answer, though a …

Tenet and three dozen other hospitals are suing Kaiser for $16 million, claiming the insurer failed to pay hospitals for care received by Kaiser patients. According to a contract, hospital giant Tenet agreed to give a discount to Kaiser patients, but only if Kaiser paid its bills on time. If Kaiser did not, it was not eligible for the discount. The two sides had been trying to negotiate an agreement on their own but talks fell apart and Kaiser refused to submit to arbitration over the …

Florida public health organization Jackson Memorial Health System, parent of the 1,776-bed public hospital behemoth Jackson Memorial Hospital, has agreed to pay $14.25 million to settle Medicare cost reporting fraud allegations with the U.S. attorney in Los Angeles. The settlement comes as part of an ongoing investigation that has implicated more than 20 hospitals and pulled in settlements of about $50 million. Jackson Memorial admitted no wrongdoing, and noted that the alleged …

Following up on the deal which won physicians a reprieve from the dreaded 5 percent Medicare fee cutback, two Senators have jointly introduced a bill including Medicare quality reporting for physicians. CMS will begin discussing possible quality measures as soon as January 2007, but doctors will not begin to report quality data in 2008, when final measures are expected to be in place. …

After years of going it on its own, Tennessee has gotten back its share of Disproportionate Share Hospital payments, at least for fiscal 2007. The state will get $131 million, which will be distributed to hospitals that treat a particularly high percentage of poor and uninsured patients. The state had given up these funds in the early 90s when it created its expanded Medicaid program, TennCare. However, since the state cut back TennCare, it has been lobbying to get the funds back. …

Sunrise, FL-based Pediatrix Medical Group has become the latest in a long series of medical and other companies facing major public embarrassment over questionable stock option practices. Pediatrix, which provides of newborn, maternal-fetal and pediatric physician sub-specialty services, employs 890 physicians in 32 states. Following an internal review, the company has concluded that it could end up recording additional compensation expenses of as much as $28 million in charges to …

So you don't get paid for services rendered--is that charity care or bad debt? Hoping to resolve this perennial question, the Healthcare Financial Management Association (HFMA) has issued new guidelines intended to help providers make such distinctions. The guidelines offer criteria for charity care policies, methods for valuation, recording and disclosure of charity care and bad debt, and classification of receipts relating to charity care. As the group notes, to date much charity care …

This week, a commission created under New York law should release a plan for shrinking the state's hospital and nursing home industries. The plan will itself become law unless the governor or legislature reject it next month. The commission's plan has developed after a year of meetings and public hearings. Observers expect the commission to require the closing of underused, financially struggling hospitals, but otherwise don't know what it will do. The state's industry is waiting with …

You think your budget is tight?  Try being a New York state-based non-profit hospital. The state's 218 non-profit facilities lost a collective $95.4 million in 2005, putting them at 49th in the country for operating margins, according to the Healthcare Association of New York State (HANYS). HANYS said that 56 percent of the state's non-profits are losing money, breaking even or running margins of less than 1 percent, a dismal situation given …

This deal has dragged on for so long that its conclusion is almost an anticlimax. Finally, after months of strife, shareholders have approved the $33 billion sale of HCA Corp. to a private investor group. The sale should represent the largest leveraged buyout in history, topping the $31.3 billion sale of RJR Nabisco in the late 80s. The buyers, which include Bain Capital, Kohlberg Kravis Roberts & Co and Merrill Lynch Global Private Equity, along with HCA managers and founder Tommy …