HealthLeaders Media Finance - September 29, 2008 | Take This Health Plan and Shove It View as a Webpage | Subscribe for Free
Take This Health Plan and Shove It
Philip Betbeze, Senior Editor-Finance

All is not right in the world of consumer-directed healthcare. Many smart people think the future of healthcare cost containment lies with these vehicles. But there's one problem I have to admit, and it pains me to do so because I think they have so much potential. People don't want them. [Read More]
  September 29, 2008

Editor's Picks
Probe: Medicare paid billions in suspect claims
Medicare may have wasted nearly $1 billion on laughably ridiculous claims that showed little relation to a patient's condition, a congressional probe has found. The probe shows that Medicare's review process cannot determine whether a claim makes sense based on a patient's condition. Much of the fraud seems to be perpetrated by suppliers. May I suggest that it's difficult to make the case that healthcare dollars can be spent wisely or efficiently by a government-administrated program? Probes like this one and others that have been released in recent months make a ?Medicare for all? program a nonstarter. I'm not advocating a free-market based approach, necessarily, but incentives for eliminating waste have to be part of any program to expand healthcare coverage. [Read More]
Obama: Wall Street bailout may delay healthcare overhaul
Once again, it seems healthcare has to take a back seat to problems others deem to be more pressing. This time it's the presumptive $700 billion (or more) bailout of Wall Street thanks to foolish and greedy decisions to loan money to those who had little hope of being able to pay it back. This time, the Obama campaign has at least acknowledged that the bailout takes precedence, but it's too early to tell how much it will affect any healthcare reform plans. Bottom line is that as a nation, we can't pay for what we're buying. Sound familiar? [Read More]
Consumers cut health spending as economy slows
I have a story coming out in HealthLeaders magazine next month on the fact that healthcare is no longer immune to economic downturns. Much of what I learned was anecdotal, but now there are statistics to back it up. Unfortunately, it looks like much of the delayed or avoided care might result in more expensive care down the road, much as delaying an oil change might with your car. [Read More]
Finance Forum
Service Line Portfolio Analysis: Identify Leaders and Laggards
Is it common knowledge among your management team which service lines are the most and least profitable? Don't be too quick to answer. You might be surprised how they hold up under analysis. Authors Francine Machisko and Aaron DeBoer take you through a detailed service line analysis to identify leaders and laggards in your service line portfolio. [Read More]
Finance Headlines
Candidates fail to address quality, cost of healthcare
Chicago Tribune - September 23, 2008
Hospitals remain cautious in helping physicians purchase EMRs
Center for Studying Health System Change - September 2008
The burgeoning business of medical offices
Charlotte Observer - September 23, 2008
Hawaii Medical Center to move Chapter 11 case
Wall Street Journal (subscription required) - September 24, 2008
Cincinnati-area healthcare costs well above national average
Cincinnati Enquirer - September 24, 2008
Health insurance costs rising faster than pay; coverage declining
Indianapolis Star - September 24, 2008
Wall Street meltdown worries New York hospitals
Wall Street Journal (subscription required) - September 22, 2008
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From HealthLeaders Magazine
10 Events That Could Change Healthcare
HealthLeaders September 2008 No one knows what the future holds, but several scenarios could significantly alter the healthcare landscape and pose formidable strategic, financial, and clinical challenges for senior leaders. Get ready. [Read More]
Money Talk

A look at one hospital's struggles to improve

Spectrum Health, Grand Rapids, MI
Rating: AAA/A1+
Outlook: Stable
Affected Debt: $67.2 million
Agency: Standard & Poor's
Remarks: Outlook revised from negative to stable based on maintenance of cash flow and ongoing improvement to the balance sheet.
[Read More]
Audio Feature

Controversy Over RAC: With the controversial Recovery Audit Contractor program going nationwide by 2010, many hospitals are concerned that while the demonstration program recovered $371 million in overpayments to hospitals, more than 96% of the improper payments were overpayments collected from providers and only 4% were underpayments repaid to providers. Further, the research conducted by my guest Michelle O'Daniel, director of member relations with VHA's West Coast office, shows that 31 VHA member hospitals were required to return nearly $46 million to CMS as a result of the audits but that once appealed, approximately 90% of the RAC rulings were overturned.
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