hospital industry

CA fines nine hospitals for putting patients at risk

Fri, 26 Oct 2007 06:59:58 -0400

California has slapped nine hospitals with $25,000 fines for putting patients at imminent risk of injury or death, marking the first time the state has fined hospitals under a new law going into effect Jan. 1. The fines, while relatively modest, set the hospital industry on more equal footing with nursing homes and health plans, which were already subject to state fines. However, hospitals still face much lower fines than nursing homes, which can be hit with $100,000 penalties.

Two fines were assessed against Martin Luther King Jr.-Harbor Hospital, which was cited in two incidents where critically-ill patients failed to get the care they needed. This included one now-famous incident in which a woman died in pain on its lobby floor without receiving medical attention. King-Harbor's hospital facilities are closed, but it still runs urgent care and outpatient clinics.

Other fined hospitals included Enloe Medical Center, Hanford Community Medical Center, Saint Agnes Medical Center, Universal Health Services, Garden Grove Hospital and Medical Center, Kaiser Foundation Hospital Santa Clara, Glendale Memorial Hospital and Feather River Hospital.

To learn more about the fines:
- read this Los Angeles Times piece

Related Article:
Kaiser assessed record-breaking $3 million fine. Report

Case study: Cincinnati Children's tracks care

Mon, 17 Sep 2007 06:59:54 -0400

Cincinnati Children's Hospital Medical Center is building a national reputation as a pediatric care center, attracting a quarter of its patients from out of its service area. It's done that, in part, by focusing on quality and efficiency measures favored by the manufacturing industry. A key part of this program is its insistence on tracking patient outcomes both within and outside of the hospital setting.

Cincinnati Children's tracks, among other things, how many patients develop surgical infections, using that data to cut the number to 42 last year from 95 in 2005, what range of motion juvenile arthritis patients achieve and how cystic fibrosis patients were functioning relative to patients at other children's facilities. This focus on data is driven by CEO James Anderson, a former head of an industrial valve maker rather than hospital industry insider.

Not only is this quality monitoring strategy well in tune with the current healthcare climate--amassing data that both governments and payors increasingly demand--it's also good business, it seems. The hospital's operating revenue has grown about 50 percent over the last three years, to over $1 billion for fiscal revenue in 2006.

To learn more about Cincinnati Children's progress:
- read this piece in The New York Times article

Related Articles:
Consumers reluctant to use outcomes, cost data. Report
Agency advocates for quality data standards. Report
Bill creates physician quality reporting system. Report
Study: Healthcare quality movement stalled. Report

ALSO NOTED: Hospitals back governor's reform plan; Texas insurer lowers med mal premiums; and much more...

Fri, 07 Sep 2007 06:59:50 -0400

> The state's hospital industry has come out in favor of Gov. Arnold Schwarzenegger's health reform plans. Article

> The largest medical malpractice insurer in Texas has lowered its rates. Article

> Florida hospitals continue sound alarms over the possible consequences if the state's no-fault auto insurance law is allowed to sunset. Article

> An attorney whose job it was to distribute the assets of a failed Pennsylvania hospital has filed suit to recover additional assets. Article

> A St. Louis health system has begun offering its employees a "personal health record" to help them self-manage their care. FierceHealthIT

And Finally... I always knew toddlers were shrewder than they looked. Article

IRS says 'uncompensated care' definition is dicey

Fri, 20 Jul 2007 06:59:58 -0400

Sure, U.S. non-profits say they deliver uncompensated care--and there's no doubt poor and uncompensated patients are getting some form of service. The problem, however, is there's no universally accepted definition for uncompensated care and community benefit reporting, according to a new IRS report.

Trade groups like the Healthcare Financial Management Association have a role, but none have established an all-hands-on-deck standard. So the IRS may issue a new Form 990 (the form used to report a non-profit's financial condition) to address this lack of standards. This could hit the hospital industry like a bomb, as it's inevitable a tighter IRS-defined standard would work against some hospitals by forcing them to reduce their community benefit estimates.

The IRS's plans follow a May 2006 survey, in which the agency checked in with about 500 tax-exempt hospitals to learn how they provide and report community benefits. Ninety-seven percent of hospitals responding to the survey said that they have a written uncompensated-care policy. But the responses trouble the agency, which fretted over a "lack of consistency or uniformity in classifying and reporting uncompensated care."

To learn more about about the IRS's plans:
- read this Modern Healthcare article (reg. req.)

Related Articles:
IRS to investigate nonprofit hospitals. Report
Proving community benefit by reducing sickness. Report
A critical time to prove community benefit. Report
A new standard for voluntary hospitals? Report
VHA: Charity policy must come from the top. Report

MD companies push Leapfrog participation

Tue, 05 Jun 2007 20:01:35 -0400

Quality measures abound in the hospital industry, and each has their virtues. This time, though, Maryland employers have focused in on a set they like, and they've begun a campaign to get hospitals on board. Baltimore and D.C.-area companies, including Lockheed Martin and Marriott, are pushing a group of 46 regional hospitals to participate in the Leapfrog Group's annual hospital quality and safety survey. The surveys, which are progressing in 32 other markets, measure progress in computerized physician order entry, ICU physician staffing, evidence-based hospital referral and quality practices. The effort is being endorsed by area health plan CareFirst BlueCross BlueShield. Leapfrog Group was founded in 2000 by several large employers and public health purchasers.

To find out more about the rollout:
- read this Leapfrog press release (.pdf)
- read this Baltimore Business Journal article

Related Article:
Businesses say "no pay" for major mistakes. Report

Wisc. hospitals may offer big uninsured discounts

Tue, 08 May 2007 20:01:36 -0400

With hospital industry pricing policies under increasing pressure, the Wisconsin Hospital Association has taken the bull by the horns. The hospital trade group is now recommending that uninsured patients automatically receive fee discounts similar to those enjoyed by managed care plans. The group is also suggesting that members work harder to let the uninsured know about charity care and financial assistance options.

WHA's recommendations aren't being made in a vacuum. Not only do its members, like hospitals across the U.S., face mounting pressure from advocacy groups, Wisconsin's facilities face scrutiny from state officials, too. In 2005, then Attorney General Peg Lautenschlager put several hospitals on notice that she wasn't happy with them charging the uninsured more than health plans. She filed a complaint against one hospital, Wheaton Franciscan Healthcare-St. Joseph, which has since agreed to discount its prices by 45 percent for uninsured patients.

To learn more about the issue:
- read this Associated Press piece

Related Articles:
Charity care under fire. Report
AHA charity proposal draws Congressional criticism. Report
A critical time to prove community benefit. Report
Senate questions charity care levels provided by hospitals. Report

Bill offers new wrongful death lawsuit options

Mon, 30 Apr 2007 20:01:36 -0400

Doctors and hospital industry groups are fuming over a bill working its way through the Illinois legislature which would expand consumers' ability to sue for wrongful death damages. The bill would allow family members of patients who die to seek compensation for "grief, sorrow and mental anguish" in addition to other forms of damages. The bill, which would extend to both accidental deaths and medical malpractice, has ignited a major controversy in the state, which is still recovering from battles over medical malpractice rates. Critics of the new bill say that it would expand wrongful death awards beyond what is appropriate, given that existing law allows for damages such as "loss of society," which takes in love, care and affection. Since 2005, the state has had a $500,000 per doctor and $1 million per hospital cap on noneconomic damages in medical malpractice cases, but relationships between providers and the state are still fragile.

To learn more about the legislation:
- read this St. Louis Post-Dispatch piece

Related Articles:
Study: Juries favor doctors in med mal cases. Report
Laws would protect physicians who apologize. Report
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Med mal "health courts" draw attention. Report

Study: Uninsured kids die more often in hospitals

Sun, 04 Mar 2007 19:01:37 -0500

Drawing a conclusion likely to be challenged at all levels of the healthcare industry, a new study by advocacy group Families USA has concluded that uninsured children do much worse in the health system than insured kids. The study, which was conducted by a researcher at the University of Arkansas for Medical Sciences, concluded that children without health insurance are twice as likely to die from injuries as insured children. It also found that uninsured children are less likely to get costly care, less likely to be offered rehab services, and get discharged earlier.

Researcher J. Mack Tilford drew this conclusion after studying two years of broad data on children's treatment, including data on 25,000 children with injuries and 6,500 with traumatic brain injuries. Tilford concluded that after controlling for age, health, severity of injury and other factors, uninsured kids had 327 "excess deaths" during that period. Hospital industry representatives disputed this conclusion, however, arguing that the sample size was small, type of hospital was not considered and that the research was not peer-reviewed.

For more data from the study:
- read this USA Today article
- read the Families USA report (.pdf)

Related Articles:
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Bush focuses on healthcare in speech

Tue, 23 Jan 2007 19:01:38 -0500

President Bush joined the national debate on universal healthcare last night with two proposals outlined in his State of the Union speech. In a previous radio address, Bush had revealed his plan to control healthcare costs by tax breaks to help low-income people buy insurance and a tax boost for employees whose health coverage costs more than average. Last night he also announced a policy to support the universal health efforts of several states. The so-called "Affordable Choices Initiative" would divert some federal money now going to hospitals and other facilities and give the money to the states. The plan would give governors more legal leeway in using Medicaid dollars if they develop smart healthcare coverage expansion strategies, moving $40 billion in disproportionate share payments away from hospitals.

Many health industry wonks are happy to see the President turn the national focus to healthcare, but Bush's plan has already drawn criticism from a number of groups. Democrats and other groups are attacking the tax deduction, which would lower taxes for 100 million citizens but raise taxes on about 30 million Americans with more expensive health plans. They also fear that employers will be less likely to provide health coverage for employees due to the tax change. And hospitals are protesting the Affordable Choices Initiative, suggesting that it could undermine their already fragile relationship with the Medicaid program and possibly push some poorer hospitals further underwater financially. Finally, the State of the Union address was important for what it didn't mention. Though the President mentioned the future financial problems Medicare and Social Security face, he didn't offer any proposal on how to deal with the problems.

For more information on the initiative:
- check out this article from the New York Times
- read the White House press release on its health proposals
- find out more about the hospital industry's lobbying efforts to block DSH program changes

Related Articles:
Bush to address health coverage. Report
Universal health model emerges. Report
Mass. objects to $380 minimum coverage price. Report

Officials Say "Prove It!" On Charity Care

Thu, 21 Dec 2006 19:01:35 -0500

Over the past year, regulators kept up the pressure on voluntary hospitals to prove that they were providing a reasonable level of charity care. Not only did the IRS continue to scrutinize tax-exempt hospitals, state tax authorities and federal legislators got their licks in, too. Overall, over the past 12 months the hospital industry has taken a pounding on this issue.

As has been the case for decades, much of the controversy has centered around the day-to-day accounting definition of charity care, with battles erupting left and right over the extent to which uncompensated care and insurance shortfalls should be counted. For example, when the American Hospital Association told members of the U.S. Senate Finance Committee that hospitals wanted to include bad debt and the gap between Medicare/Medicaid payments and costs in the tally, it didn't go over very well.

Hoping to create common ground, a number of industry organizations came out with charity care guidance for hospitals this year. For example, Catholic Hospital Association and the Healthcare Financial Management Association weighed in on how to account for such care appropriately, while consulting firm PriceWaterhouseCoopers issued its own guidelines coaching hospitals on how to get their charity care contributions publicity and buy-in from their communities.

While these guidelines are spurring discussion--and serving as a handy yardstick for hospital administrators--I don't think any major new ground was broken here. Still, the fact that several groups chose 2006 as the year to take a stand on charity care means something. Look for the charity care issue to get even hotter in 2007, as the Democrats hit their stride as the majority party in Congress and work to make some visible reforms prior to the '08 presidential campaign.