Like airlines that offer first-class and coach sections, dermatology is becoming a two-tier business in which higher-paying customers receive greater pampering. In some dermatologists' offices, free spending cosmetic patients are given appointments more quickly than medical patients for whom health insurance pays fixed reimbursement fees. In other offices, cosmetic patients spend more time with a doctor, and sometimes doctors employ a special receptionist, called a cosmetic concierge, for their beauty patients. Some say the trend creates the message that the cosmetic patient is more important than the medical patient.
Numerous Birmingham, AL-area hospitals are starting to branch out from the urban core and locate in surrounding suburbs, but competition among them guarantees that all such moves will be long and drawn out through the state regulatory process. The regulatory process is intended to keep healthcare costs in check by preventing unnecessary duplication of services, but its critics believe it does the opposite by stifling competition.
Winston-Salem-based hospital chain Novant Health wants to build a 46-bed, $110 million hospital in Holly Springs, NC, but it will face a battle to win approval from the state. Novant Health announced plans for the Holly Springs hospital that would serve the town and southwest Wake County. If Novant wins approval, it would hire 200 to 300 people and open in 2012. It plans to submit its application to state regulators Aug. 15, but approval will likely be hard-fought because the plan would use up all the new hospital beds that state regulators have allocated for Wake County.
An untold number of people have been rejected for medical coverage because insurance companies are using huge, commercially available prescription databases to screen out applicants based on their drug purchases. Privacy and consumer advocates warn that the information can easily be misinterpreted or knowingly misused. The practice is adding another layer of anxiety to a marketplace that many consumers already find baffling, reports Business Week. The obstacle primarily confronts people seeking individual health insurance, not those covered under an employer's plan.
Fancy touches and posh chemotherapy clinics at the $150 million, 405,000-square-foot Indiana University Simon Cancer Center facility are expected to help draw cancer patients from across the state and the country. The hospital, which will begin accepting patients at the end of August, has 34 chemo treatment spaces and may expand to 60. Patients can opt for a private room with a bathroom, or they can sit in semi-private spaces and shield themselves from the next patient with sliding wood doors with opaque windows. Inpatient rooms come with similar personal touches in an effort to make patients and visitors feel comfortable.
A long time ago, Atlanta's mostly white business elite and the mostly black political leadership decided to be pragmatic. They crafted a kind of civic peace treaty known as "the Atlanta way" that allowed commerce to thrive and the city to grow, all the while maintaining peaceful race relations that tagged Atlanta as "the city too busy to hate."
Not everyone views the relationship as being mutually beneficial, but the results are hard to dispute. From the poorest region of the country, my hometown emerged as a modern capital, an international corporate hub, and the host of the Olympic Games. The one problem that "the Atlanta way" could not fix, at least until this week, was the disaster known as Grady Memorial Hospital.
On Monday, Grady's new nonprofit board of directors hired Michael Young, CEO of Erie County Medical Center, becoming the sixth Grady CEO since 2005. There is reason to hope that Young—a proven turnaround leader—will finally be the one to save Grady from itself.
On the same day Young was hired, the board reportedly paid the fifth CEO since 2005, state legislator Pam Stephenson, $325,000 to leave after six months of work, for which, as the Atlanta-Journal Constitution adds, "she had no real qualifications for in the first place." Her departure also ended questions over her original two-year contract, which was approved by the previous board, which she just happened to chair.
There is reason to hope that the politics that have been the root of disease at Grady for so long are in the past. The new 17-member nonprofit board is full of heavyweights, including A.D. "Pete" Correll, chairman emeritus of Georgia Pacific; Dr. Louis Sullivan, the former secretary of Health and Human Services; Atlanta School Superintendent Beverly Hall, and Cousins Properties CEO Thomas Bell. In addition to their leadership and business skills, the new board has already received commitments for $200 million in donations with the prospect of $100 million more. As with any other city, big-money donors run in elite circles who usually only trust donations to charitable causes within that circle. Up until now, Grady was on the outside.
What I believe is the single differentiator and what gives Young and his new team a fighting chance is that this new board stands to gain nothing from Grady. Questions of politics and conflicts-of-interest should remain in the past.
Will "the Atlanta way" work? The payer mix is still dreadful because the state government generally treats Atlanta's problems as Atlanta's problems when the Medicaid checks are written. Paying customers long ago fled the inner city to hospitals outside the I-285 perimeter.
It's too trite to say Grady can't fail now. You don't turn around decades of decline easily. But at least the city is using some reliable civic tools now to move forward.
Jim Molpus is Editor-in-Chief of HealthLeaders Media. He can be reached at jmolpus@healthleadersmedia.com.
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