elective procedures

Fewer paying patients causes downward spiral for hospitals

Dan Bowman — Fri, 07 Nov 2008 12:07:11 -0500

Hospitals across the country have reported that fewer patients are opting for procedures such as knee replacements, hernia repairs and weight-loss surgeries, mainly because of the state of the economy. In addition, more people who make visits to the emergency room are struggling to pay their bills. For some hospitals, the decrease in income could mean less charity care, considering that the money brought in from those elective treatments tends to subsidize both charity care and unpaid medical bills.

Florida non-profit system Shands HealthCare recently closed a 367-bed hospital in Gainesville after losing $12 million last year, unable to deal with the hemorrhaging economic situation. "We cannot carry it anymore," said Timothy Goldfarb, the system's chief executive.

Other hospital systems are making sacrifices to survive. The University of Pittsburgh Medical Center, for example, is set to cut 500 jobs, citing a "tailing off" of growth. "[Growth has been] much, much slower than we've seen in years past," said Robert A. DeMichiei, Pittsburgh's chief financial officer.

No matter how you slice it, this appears to be a problem that could go on for quite some time.

Fore more information:
- here's the New York Times article

OH plans, providers share pricing and quality information

Fri, 23 May 2008 06:59:55 -0400

This week seems to be a big one for transparency. Not only did Cigna roll out its nationwide physician and hospital rankings program nationwide, central Ohio got into the action, too. Anthem Blue Cross and Blue Shield in Ohio has published pricing information on medical procedures on a site accessible only to its members this week. Anthem's tool tells members what's paid to providers after contract discounts for 39 common elective procedures.

The move follows similar steps by providers, for example, local health system OhioHealth, which began publishing CMS data on patient care and satisfaction a couple of weeks ago. Also, OSU Medical Center published its data from CMS in late March, with Nationwide Children's Hospital planning to follow up with its own data this summer.

Aetna, meanwhile, has offered its members price information for physicians in central Ohio since 2006, along with a system rating doctors with stars, as well as by rates of patients readmitted to hospitals within 30 days after discharge.

To learn more about transparency in central Ohio:
- read this Business First of Columbus piece

Related Articles:
Critics doubt benefit of posting hospital prices online
Tennessee hospitals put prices online
MN group posts hospital prices to Web
Maryland adds pricing to hospital guide

Hospital services pre-payment may loom large in future

Fri, 09 May 2008 06:59:59 -0400

Recently, we've covered a variety of news that touched on the issue of whether hospitals should get tough about collecting from patients prior to delivering care for elective procedures. Most of it suggests that this is a risky strategy, at least politically:

* The Wall Street Journal ran a very unflattering piece on the M.D. Anderson Cancer Center's decision not to treat a leukemia patient until she coughed up $100,000 in cash.

* Perhaps in response to the WSJ story--or others like it--the Minnesota legislature just passed a measure forbidding the state's hospitals from investigating a patient's medical debt prior to treating them.

* According to one blog, an ED surgeon recently was sued under EMTALA because he gave a patient a realistic estimate of costs during treatment and the patient went elsewhere.

This is a difficult situation, and it's going to get nastier, particularly if reform-minded types take over the White House this year. Why? Because historically, hospitals have been asked to carry many of the costs of system, and policy-makers don't always bear in mind that they don't have the resources.

On the other hand, hospitals aren't completely helpless. As our sister publication, FierceHealthFinance, points out, hospitals often can do much more to qualify patients for various forms of charity care and public assistance, as well as collect from self-pay patients after the fact. That, at least, is a start.

Other than that, I suspect it's time for even the least politically minded hospital executives among us to become active. Make your case on the local, state and even federal level. Otherwise, our political leaders may continue to assume--as some seem to now--that you're the bad guys. - Anne