HealthLeadersMedia.com - Finance News & Analysis

NJ Hospital Will Pay $6.35M to Resolve Whistleblower Allegations

Fri, 19 Mar 2010 17:38:00 GMT

Robert Wood Johnson University Hospital Hamilton will pay $6.35 million to settle two whistleblower lawsuits alleging that the New Jersey hospital inflated outlier billings to Medicare, the Department of Justice announced.

Detroit Medical Center Sale Raises Concerns About Charity Care

Fri, 19 Mar 2010 17:13:00 GMT

Detroit Medical Center, Michigan’s largest charity care provider, signed a letter of intent to negotiate the eight-hospital system’s sale to private Vanguard Health Systems, Inc. The purchase price will include approximately $417 million to retire all outstanding DMC bonds and other long-term indebtedness, and also requires Vanguard to assume all DMC liabilities.

Both Sides of Health Reform Debate Preparing for Sunday Vote

Fri, 19 Mar 2010 15:44:00 GMT

Fasten your seat belts, it should be an interesting weekend as the House appears ready to vote on Sunday afternoon on the House healthcare reform package. Democrats are closing in on the magic number of 216 votes, but because at least two dozen Democrats remained undecided, the total appears not to have been reached yet.

10 Major Changes to Health Reform in House's Reconciliation Bill

Fri, 19 Mar 2010 12:26:00 GMT

The House Rules Committee has issued its 153-page reconciliation proposal on Thursday that makes "legislative fixes" to the Senate health reform measure. Here’s a sample of some the major changes made to the Senate bill.

Cardiology Group Fights Medicare Pay Cuts by Offering Concierge Services

Fri, 19 Mar 2010 12:21:00 GMT

For President Richard Wright, MD, and eight other cardiologists with the Pacific Heart Institute in Santa Monica, CA, a Medicare cut on Jan. 1 was one too many. That’s why the group will start charging patients between $500 and $7,500 for special "extended" access services and same-day appointments.

Hospitals' Sustainability Managers Look for Savings through Better Environmental Practices

Fri, 19 Mar 2010 12:14:00 GMT

Many hospitals already have green teams of ecology-minded employees who strategize ways to reduce waste and energy consumption, but some medical centers have taken things a step further by creating a full-time position for the management of environmental initiatives.

Democrats say health bill will pay for itself in the long run

Fri, 19 Mar 2010 12:08:00 GMT

House Democrats have unveiled a nearly final version of healthcare legislation that promptly won additional support with a promise that the bill would more than pay for itself over the next decade. The legislation’s chances seemed to be improved by a report on the bill’s costs from the Congressional Budget Office, which estimated that it would reduce projected federal budget deficits by $138 billion over the next decade with additional tax revenue and Medicare savings, the New York Times reports.

CBO: Package would save money with new taxes and curbs on Medicare spending

Fri, 19 Mar 2010 12:07:00 GMT

The latest version of the Democrats’ health overhaul costs $940 billion over a decade, yet it would bring down the federal budget deficit by $138 billion, according to the nonpartisan Congressional Budget Office. The cost includes $466 billion to give tax credits to help lower earners buy insurance, $434 billion to expand the Medicaid federal-state insurance program for the poor, and $40 billion in tax credits to help small businesses offer coverage. The CBO said the Senate bill by itself would reduce the federal budget deficit by $118 billion over a decade compared with current law. That’s because the new taxes and spending cuts are greater than the cost of expanding insurance coverage, the Wall Street Journal reports.

Texas company giving its ERs support to run more efficiently

Fri, 19 Mar 2010 12:04:00 GMT

A Texas company aims to run emergency departments more efficiently, and is promising patients no longer than a 15-minute wait to see a doctor or the medical care is free. The Woodlands-based 24 Hour Emergency Room, in business for five years, operates four stand-alone locations in Texas. "Our business model doesn’t allow us to take on high volumes of uninsured patients who are also unable to pay with cash because of the expense involved with running our facilities," said Hemant Vankawala, medical director of 24 Hour Emergency Room at The Hospital at Craig Ranch in McKinney.

TennCare postpones some cuts for a year

Fri, 19 Mar 2010 11:54:00 GMT

TennCare officials announced they will be able to use a federal refund of $121 million to postpone some cuts to Tennesee’s expanded Medicaid program for a year. Gov. Phil Bredesen has said he needs to cut $201 million from TennCare, which has about 1.2 million enrollees, to balance the state budget. TennCare director Darin Gordon said limitations on non-emergency outpatient visits, physician procedures and implementation of a $2 copay on non-emergency transportation are among items that will be postponed for a year.

Massachusetts hospital executive says network trying to become less pricey

Fri, 19 Mar 2010 11:41:00 GMT

A top executive from Partners HealthCare, the large Massachusetts hospital and physician network that has been blamed by some for helping to push up healthcare costs, said the organization realizes it’s too costly and is working to become less expensive. But Thomas Glynn, chief operating officer for Partners, testified under oath at a state hearing that while prices charged by better-paid hospitals and doctors have contributed to rising healthcare costs, they do not have as big of a role as state regulators have suggested, the Boston Globe reports.

Health insurers toughen stance in disputes over hospital rates

Fri, 19 Mar 2010 11:24:00 GMT

Health insurers are fighting demands by hospitals for higher reimbursement rates by threatening to drop the hospitals from their health-plan networks and blaming them for higher insurance premiums, the Wall Street Journal reports. Hospitals argue that low Medicare rates and cuts to Medicaid mean that hospitals have to get money from elsewhere, and increasingly that is private insurers. Rising ranks of uninsured Americans have led to more uncompensated care and have swelled the rolls of Medicaid, exacerbating the problem, reports the Journal.

Arizona drops children's health program

Fri, 19 Mar 2010 11:21:00 GMT

Arizona became the first state to eliminate its Children's Health Insurance Program when Gov. Jan Brewer signed a budget that will leave nearly 47,000 low-income children without coverage. The state also will roll back Medicaid coverage for childless adults in a move that is expected to eventually drop 310,000 people from the rolls. Hospital officials and advocates for low-income people said they were worried that emergency rooms would be overrun by patients who had few other options for care, and that children might suffer enduring developmental problems because of inadequate medical attention, the New York Times reports.

State Suspends Medicare Advantage Salesman for Fraudulent Tactics

Thu, 18 Mar 2010 12:41:00 GMT

A Southern California health plan sales agent used "deceptive, misleading, aggressive, and abusive sales tactics" to persuade elderly individuals into switching their Medicare Advantage plan by telling them falsely that the plan he was selling would let them see their physicians, California officials said.

Miami-based Jackson Health System stays afloat by delaying bills

Thu, 18 Mar 2010 12:32:00 GMT

Dozens of suppliers to Miami-based Jackson Health System are owed more than $17 million in bills that are more than 90 days old, according to documents released to the Miami Herald under a public records request. For Jackson, it signals a dire financial situation that could instantly trigger a new governing board under several proposals the Miami-Dade County Commission is expected to consider, the Herald reports. For the past year, Jackson’s money managers have kept the troubled system afloat by delaying payments to vendors.

New Idaho Law Would Allow AG to Sue Feds if Health Reform Passes

Thu, 18 Mar 2010 12:31:00 GMT

Idaho has become the first state to implement a law that would require the state’s attorney general to sue the federal government if Congress passes the current health reform legislation.

Medicare payments for physical therapy have poor prognosis

Thu, 18 Mar 2010 12:27:00 GMT

Because of a little-known provision in the law and Washington’s stalemate over healthcare, more than half a million physical therapy patients across the country may soon see an end to Medicare payments for their treatments. That means they will have to pay for the sessions themselves, hope other insurance picks up the tab, go to a hospital for help, or simply stop getting treatment. Medicare patients are in this fix because in 1997 Congress set a hard cap on Medicare payments for physical therapy at clinics, nursing homes, and doctors’ offices—anywhere outside a hospital, the Los Angeles Times reports.

WellPoint's giving for uninsured falls short, records show

Thu, 18 Mar 2010 12:25:00 GMT

In 2007, insurer WellPoint, Inc. pledged that its charitable foundation would spend $30 million over three years as part of a "comprehensive plan to help address the growing ranks of the uninsured." But according to tax filings, company promotional material, and former executives familiar with the initiative, WellPoint never came close to fulfilling that pledge. WellPoint’s public records indicate that from 2007 to 2009 the foundation gave less than $6.2 million in grants targeted specifically at helping uninsured Americans get access to coverage and care. That is barely one-fifth of what was promised and just 11% of the charity’s total giving over the last three years, the Los Angeles Times reports.

Putting a dollar figure on a doctor's worth to a hospital

Thu, 18 Mar 2010 12:23:00 GMT

What’s a doctor worth to a hospital in terms of annual revenue? The answer averages about $1.54 million a year, based on 114 U.S. hospital responding to a survey by physician recruiters Merritt Hawkins. That’s up slightly from the $1.5 million a year per doctors that hospitals averaged in revenue in 2007, the last time Merritt Hawkins took the survey. Merritt Hawkins also asked about revenue generation in the last 12 months by 17 doctor specialties.

Pure Genius: TPA and Hospital Collaborate to Decrease Denials and Save

Mon, 15 Mar 2010 14:50:00 GMT

Claims processing has been a slow and inefficient process on both sides, leading to large financial losses. After years of back and forth, someone is trying to fix it.